NEW PARAMETERS IN THE DUPLEX STUDY OF THE CAROTID ARTERIES IN RECENT ISCHAEMIC CEREBRAL STROKES

Intima-media thickness as an evidence of atherosclerosis was always a matter of concern, but correlating this with other duplex parameters as velocities, indices, cross sectional surface area, and luminal diameters was defective. Therefore in the current study we measured the intima-media thickness (IMT), peak systolic and end diastolic velocities, resistivity and pulsitility indices, cross sectional surface area, and luminal diameters of the carotid arteries using duplex , comparing 40 patients having recent ischaemic stroke (20 diabetics and 20 non-diabetics) with 20 healthy control subjects. It revealed significant increase in the IMT in acute stroke patients (more in diabetics then non-diabetics). The increase in IMT was bilateral, with significant increase in the end diastolic velocity, pulsitility, resistivity indices, and surface area of internal carotid artery, as well as significant reduction of the luminal diameter in patients with stroke compared with control subjects. Patients with ischaemic heart disease; as confirmed by ECG and Echocardiography, have higher IMT, peak systolic velocity and resistivity indices than patients without ischaemic changes. We might conclude that measuring mechanical and hemodynamic parameters in addition to intima-media thickness may be of great importance in studying the cardiovascular effects of atherosclerosis in vulnerable groups even before ihe development of cardiovascular events, especially in diabetic patients.