Stenotic occlusive lesions of internal carotid artery in diabetic patients

Scientific paper - Original scientific paper

• Author: Vinko Vidjak
• Author: Andrija Hebrang
• Author: Boris Brkljačić
• Author: Ante Barada
• Author: Mladen Brajša
• Author: Zoran Brnić
• Author: Karlo Novačić
• Author: Ante Grga
• Author: Dubravko Hlevnjak
• Author: Zlata Flegar-Meštrić
• Author: Danijela Vrhovski-Hebrang
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Diabetes deteriorates atherosclerotic changes in the arteries. The aim of the study was to assess the prevalence and localization of stenotic atherosclerotic lesions of the internal carotid artery (ICA) in patients with diabetes. A prospective analysis of angiography findings was carried out in 150 diabetic and 150 non-diabetic patients with symptoms of cerebral ischemia using double-blind angiogram readings by two independent investigators. The degree of stenosis was determined using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Stenoses of the proximal arterial segment accounted for the majority of extracranial ICA stenoses, being more frequent in diabetic (left ICA 50.7%, right ICA 58.0%) than in the non-diabetic patients (left ICA 29.3%, right ICA 32.7%). Diabetic patients revealed a more significant rate of unilateral tandem ICA stenoses (14.0-21.3%), as well as a statistically significantly higher prevalence of intracranial ICA stenoses (left ICA 24.0% and right ICA 17.3%) than did non-diabetic patients (left and right ICA 3.3% each). Our results confirm that there is a morphological basis in ICA for increased incidence of ICA lesions in patients with diabetes as compared to those without it. Data on the incidence of stenotic ICA lesions in diabetes suggest the importance of assessing overall ICA status using digital subtraction angiography. Such an assessment is a precondition for an optimal therapeutic approach, especially in diabetic patients who are at an increased risk of cerebrovascular disease.

Abstract (croatian)

Šećerna bolest doprinosi razvoju aterosklerotskih promjena na arterijama. Cilj istraživanja bio je odrediti učestalost i lokalizaciju stenotičnih aterosklerotskih promjena unutarnje karotidne arterije (ACI) u dijabetičkih bolesnika. Metodom dvostrukog slijepog očitavanja angiograma od strane dva nezavisna ispitivača prospektivno su analizirani angiogrami 150 dijabetičkih i 150 nedijabetičkih bolesnika sa simptomima ishemijske bolesti mozga. Stupanj stenoze ACI određivan je sukladno kriterijima North American Symptomatic Carotid Endarterectomy Trial (NASCET). Većinu stenoza ekstrakranijalnog dijela ACI čine one na proksimalnom dijelu arterije, a brojnije su u dijabetičkih bolesnika (lijeva ACI – 50,7%, desna ACI – 58,0%) nego u bolesnika bez dijabetesa (lijeva ACI – 29,3%, desna ACI – 32,7%). Kod dijabetičkih bolesnika nađena je značajnija unilateralna zastupljenost tandem stenoza ACI (14,0–21,3%), kao i statistički značajno veća učestalost stenoza intrakranijalnog (i.c.) dijela ACI (lijeva ACI i.c. – 24,0%; desna ACI i.c. – 17,3%) u usporedbi s bolesnicima bez šećerne bolesti (lijeva ACI i.c. – 3,3%; desna ACI i.c. – 3,3%). Rezultati potvrđuju kako u dijabetičkih bolesnika postoji morfološka osnova povećane incidencije promjena na ACI u odnosu na bolesnike bez dijabetesa. Spoznaja o učestalosti razvoja stenotičnih promjena ACI kod dijabetičkih bolesnika naglašava važnost procjene cjelokupnog statusa ACI digitalnom suptrakcijskom angiografijom. Takva je procjena preduvjet optimalnog pristupa liječenju, osobito bolesnika sa šećernom bolešću koji su izloženiji povećanom riziku razvoja cerebrovaskularne bolesti.

• Keywords (english): Carotid Artery, Internal; Carotid Stenosis - epidemiology - pathology - radiography; Diabetes Complications - epidemiology - pathology - radiography; Adult; Aged; Angiography, Digital Subtraction; Case-Control Studies; Croatia - epidemiology; Double-Blind Method; Female; Humans; Incidence; Male; Middle Aged; Prospective Studies
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 31, no. 3, pp. 775-780
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:818687
• Publication: 2007-09
• Document URL: https://hrcak.srce.hr/26892
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 10:53:48