Prevalence of Asymptomatic Atherosclerotic Plaque at Carotid Bifurcation in Individuals of 20-70 years of Age TC05-TC08
Dr. Amit Kumar Choubey,
Head, Department of Radiodiagnosis, Indian Naval Hospital Ship Sanjivani, Naval Base, Kochi-682004, Kerala, India.
Introduction: Stroke is the second most common cause of death worldwide. Among 20-30% of all ischaemic infarcts are caused by carotid artery stenosis. Computed Tomography Angiography (CTA), Magnetic Resonance Angiography (MRA), Digital Subtraction Angiography (DSA) and duplex imaging are the available modalities for evaluation of extracranial atherosclerosis. Duplex imaging for Carotid Intima-Media Thickness (CIMT) and plaque evaluation in carotid vessels is a good screening tool for atherosclerosis. No prevalence study for carotid atherosclerosis is available in Indian population.
Aim: To determine the prevalence of asymptomatic atherosclerotic plaques and asymptomatic critical stenosis at carotid bifurcation in individuals of 20-70 years of age.
Materials and Methods: The present prospective consecutive cross-sectional study was carried on 250 volunteers (125 males and 125 females) in the 20-70 years age group with no history of TIA/cerebral ischaemic stroke with 50 subjects in each decade. The carotid arteries of volunteers were screened by duplex imaging. Descriptive and inferential statistical analysis was carried out by statistical software SPSS 15.0. Results on categorical measurements were presented in Number (%).
Results: Overall prevalence of carotid plaque was 14% in 20-70 years of age. Prevalence of plaque in Common Carotid Artery (CCA), Internal Carotid Artery (ICA) and External Carotid Artery (ECA) was 4%, 10% and 0.4% respectively. Plaque prevalence was 2%, 4%, 2%, 24% and 38% in age groups of 20-30 years, 31-40 years, 41-50 years, 51-60 years and 61-70 years respectively. Prevalence of percentage stenosis was 2% for 50-69% stenosis and 0.4% for >69% stenosis.
Conclusion: In the present study, the overall prevalence of Carotid plaque was 14% and prevalence of percentage stenosis was 0.4% for >69% stenosis. So screening of asymptomatic population for carotid atherosclerosis is not recommended in view of low prevalence rate of significant stenosis and the management will remain same based on standard preventive therapy.