The Correlation Between Carotid Atherosclerotic Plaque And Acute Ischemic Stroke Of Anterior Circulation

Objective Statistics of carotid atherosclerotic plaque incidence in patients with acute ischemic stroke(AIS) of anterior circulation. analysis the relationship between carotid atherosclerotic plaque nature, stenosis rate, distribution and acute ischemic stroke of anterior circulation. explore the related risk factors of carotid atherosclerosis plaque and acute ischemic stroke of anterior circulation. Evaluate the clinical significance of FLAIR hyperintense vessel sign(FHVs).Methods According to the diagnostic criteria of ischemic stroke in “Diagnosis and treatment of acute ischemic stroke guidelines in Chinese-2014”. Collected 188 patients with Ischemic stroke of anterior circulation and first onset from June 2013 to March2015 in the Department of Neurology. 150 cases of non-cerebral vascular disease patients in our department were selected as control group. All patients underwent head MRI, neck vascular color Doppler ultrasound and blood biochemical detection within24 hours. The general data of patients in AIS group and control group were collected,including gender, age, past history, medication history and risk factors of cerebrovascular disease. Compared the differences of plaque stability, artery stenosis,the distribution between the two groups. Analysis the risk factors of carotid artery plaque and Anterior circulation ischemic stroke. Statistics the detection of FHVs in two groups and explore the clinical significance of FHVs.Results The detection of acute anterior circulation ischemic stroke patients withcarotid atherosclerotic plaque was 72.3%, significantly higher than the control group(54.7%, P<0.05). The detection rate of unstable plaques in AIS group was 54.8%,significantly higher than in the control group(31.3%)(P < 0.001). AIS patients with carotid artery stenosis was higher(P < 0.001), and the severe stenosis proportion was more obvious. The bilateral carotid artery plaque detection rate in AIS group was64.7%, distribution range wider, than the control group(60.9%)(P < 0.05). In the ischemic stroke patients, the detection rate(62.3%) of carotid artery plaque on the infarction side was higher than that of the non-infarction side(57%). Distribution of carotid plaque showed most in the carotid artery bifurcation(77.6%), followed by the common was distal carotid artery(19%), proximal internal carotid artery and external carotid artery plaque was uncommon. Logistic Multivariate correlation analysis showed that the stability of carotid plaque(OR=2.236) and smoking(OR=3.611) were the independent risk factors for AIS. Age(OR=1.10), male(OR=0.38), hypertension(OR=2.86) and smoking(OR=2.695) were independent risk factors for carotid atherosclerotic plaque. In AIS patients, only 180 patients with FLAIR sequence showed a more clear internal carotid artery,the detection rate of FHVs was 80%. 146 patients of control group showed clearly with internal carotid artery, FHVs detection rate of internal carotid artery was 63%. The two groups had statistical differences in detection rate of internal carotid artery FHVs(c2=11.638, P<0.001).Conclusion Carotid atherosclerotic plaque is an important risk factor of acute anterior circulation ischemic stroke. The degree of carotid artery stenosis is closely related to acute ischemic stroke. Plaque stability and smoking are independent risk factors for ischemic stroke. Age, male gender, hypertension, smoking are independent risk factors of carotid artery plaque. we should not only pay attention to the artery stenosis, but also to the stability of atherosclerotic plaque. FHVs has an important value in the evaluation of atherosclerosis in ischemic stroke, but it needs further study.