PREVALENCE OF SIGNIFICANT INTERNAL CAROTID ARTERY STENOSIS AMONG ISCHEMIC STROKE PATIENTS WHO HAD CAROTID DOPPLER STUDY IN ZEWDITU MEMORIAL HOSPITAL, ADDIS ABABA, ETHIOPIA: A 4-YEAR HOSPITAL‑BASED DESCRIPTIVE CROSS-SECTIONAL STUDY

Abstract

Abstract Background: Cerebrovascular accident is an important health problem worldwide. Globally, ischemia accounts for 62% of all incident strokes. Atherosclerosis is one of the major causes of ischemic stroke. 15-20% of ischemic stroke is estimated to be caused by internal carotid artery stenosis of ≥ 50%. Smoking, old age, male sex, increasing blood pressure, hyperlipidemia and diabetes mellitus are associated with an increased prevalence of significant internal carotid artery stenosis. Doppler Ultrasound plays an important role in establishing the presence and severity of extra cranial arterial atherosclerosis, stenosis and or occlusion in ischemic stroke. Objective: The aim of this study was to study the prevalence of internal carotid artery stenosis and to assess the significance of common risk factors for internal carotid artery stenosis in ischemic stroke patients admitted to Zewditu Memorial Hospital. Methods: This was a 4-year descriptive cross sectional study of ischemic stroke patients who have Doppler study of bilateral carotid artery from September, 2018 to August 2022. All ischemic stroke patients with Doppler ultrasound of bilateral carotid artery were used as study population. Significant ICA stenosis was defined as internal carotid artery stenosis of ≥50%. Data was entered into the Epi-data version 3.1 and analyzed using SPSS version 25. Result: A total of 591 card numbers with a diagnosis of ischemic stroke were collected from HMIS. Of these only chart of 412 patients was able to be found from card room. Among these 158 patients fulfilled inclusion criteria and included in the study. There were 66 males (41.8%) and 92 females (58.2%) with minimum age of 34 and maximum 90, with a mean value of 63 years. 6 (3.8%) had moderate (CAS ≥50% - 69%) stenosis, 2 (1.3%) had severe (CAS ≥70% -99%) stenosis and none of them had total occlusion. Conclusion and Recommendation: Among ischemic stroke patients who had Doppler study of Internal carotid artery the prevalence of significant internal carotid artery stenosis is low (5.1%). This finding raise question regarding the applicability and cost-effectiveness of routine carotid ultrasound screening in our study area. We recommend further large scale multi centered prospective study for better characterization of patients with ischemic stroke. Key words: Doppler ultrasound, Internal Carotid Artery, Ischemic stroke, Zewditu Hospital