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Article: Risk, types, and severity of intracranial hemorrhage in patients with symptomatic carotid artery stenosis

TitleRisk, types, and severity of intracranial hemorrhage in patients with symptomatic carotid artery stenosis
Authors
Issue Date2003
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.org
Citation
Stroke, 2003, v. 34 n. 8, p. 1847-1851 How to Cite?
AbstractBackground and Purpose - We sought to report the occurrence and risk factors of intracranial hemorrhage during long-term follow-up of patients with internal carotid artery stenosis, with and without carotid endarterectomy. Methods - From the prospective data of the North American Symptomatic Carotid Endarterectomy Trial, 3 types of intracranial hemorrhage were recognized: Petechiae within infarction (PTI), intracerebral hematoma (ICH), and subarachnoid hemorrhage (SAH). The 30-day and 5-year risks of intracranial hemorrhage (PTI or ICH) were estimated from Kaplan-Meier event-free survival curves. Cox proportional-hazards regression modeling was used to identify risk factors. Results - Of 1039 strokes that occurred in 749 of 2885 patients during an average follow-up of 5 years, there were 24 PTIs, 14 ICHs, and 1 SAH. The 5-year risk of intracranial hemorrhage was 1.7% in both medically and surgically treated patients, but the 30-day risk of 0.64% in surgically treated patients was 10 times higher than the risk of 0.07% in medically treated patients (P=0.01). Approximately 50% of all intracranial hemorrhages were either disabling or fatal, and ICHs were more likely to be fatal than PTIs. Old age, a history of hypertension, intermittent claudication and smoking, and infarct on brain images were risk factors for intracranial hemorrhage in medically treated patients, whereas diabetes mellitus was the sole risk factor in surgically treated patients. Conclusions - Intracranial hemorrhages are uncommon in patients with internal carotid artery stenosis but are associated with high mortality and morbidity. The risk factors for intracranial hemorrhage are different between medically and surgically treated patients.
Persistent Identifierhttp://hdl.handle.net/10722/77094
ISSN
2015 Impact Factor: 5.787
2015 SCImago Journal Rankings: 3.671
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, RTFen_HK
dc.contributor.authorEliasziw, Men_HK
dc.contributor.authorMeldrum, HEen_HK
dc.contributor.authorFox, AJen_HK
dc.contributor.authorBarnett, HJMen_HK
dc.date.accessioned2010-09-06T07:28:12Z-
dc.date.available2010-09-06T07:28:12Z-
dc.date.issued2003en_HK
dc.identifier.citationStroke, 2003, v. 34 n. 8, p. 1847-1851en_HK
dc.identifier.issn0039-2499en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77094-
dc.description.abstractBackground and Purpose - We sought to report the occurrence and risk factors of intracranial hemorrhage during long-term follow-up of patients with internal carotid artery stenosis, with and without carotid endarterectomy. Methods - From the prospective data of the North American Symptomatic Carotid Endarterectomy Trial, 3 types of intracranial hemorrhage were recognized: Petechiae within infarction (PTI), intracerebral hematoma (ICH), and subarachnoid hemorrhage (SAH). The 30-day and 5-year risks of intracranial hemorrhage (PTI or ICH) were estimated from Kaplan-Meier event-free survival curves. Cox proportional-hazards regression modeling was used to identify risk factors. Results - Of 1039 strokes that occurred in 749 of 2885 patients during an average follow-up of 5 years, there were 24 PTIs, 14 ICHs, and 1 SAH. The 5-year risk of intracranial hemorrhage was 1.7% in both medically and surgically treated patients, but the 30-day risk of 0.64% in surgically treated patients was 10 times higher than the risk of 0.07% in medically treated patients (P=0.01). Approximately 50% of all intracranial hemorrhages were either disabling or fatal, and ICHs were more likely to be fatal than PTIs. Old age, a history of hypertension, intermittent claudication and smoking, and infarct on brain images were risk factors for intracranial hemorrhage in medically treated patients, whereas diabetes mellitus was the sole risk factor in surgically treated patients. Conclusions - Intracranial hemorrhages are uncommon in patients with internal carotid artery stenosis but are associated with high mortality and morbidity. The risk factors for intracranial hemorrhage are different between medically and surgically treated patients.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.orgen_HK
dc.relation.ispartofStrokeen_HK
dc.rightsStroke. Copyright © Lippincott Williams & Wilkins.en_HK
dc.subject.meshCarotid Stenosis - epidemiology - surgeryen_HK
dc.subject.meshComorbidityen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshEndarterectomy, Carotid - statistics & numerical dataen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIntracranial Hemorrhages - epidemiology - mortalityen_HK
dc.subject.meshMulticenter Studies as Topic - statistics & numerical dataen_HK
dc.subject.meshNorth America - epidemiologyen_HK
dc.subject.meshProportional Hazards Modelsen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRandomized Controlled Trials as Topic - statistics & numerical dataen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshRisk Factorsen_HK
dc.titleRisk, types, and severity of intracranial hemorrhage in patients with symptomatic carotid artery stenosisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0039-2499&volume=34&spage=1847&epage=1851&date=2003&atitle=Risk,+types,+and+severity+of+intracranial+hemorrhage+in+patients+with+symptomatic+carotid+artery+stenosisen_HK
dc.identifier.emailCheung, RTF:rtcheung@hku.hken_HK
dc.identifier.authorityCheung, RTF=rp00434en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1161/01.STR.0000080523.29138.5Fen_HK
dc.identifier.pmid12829862-
dc.identifier.scopuseid_2-s2.0-0042122510en_HK
dc.identifier.hkuros87545en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0042122510&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1847en_HK
dc.identifier.epage1851en_HK
dc.identifier.isiWOS:000184482100007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCheung, RTF=7202397498en_HK
dc.identifier.scopusauthoridEliasziw, M=7006229742en_HK
dc.identifier.scopusauthoridMeldrum, HE=6701684042en_HK
dc.identifier.scopusauthoridFox, AJ=7402907074en_HK
dc.identifier.scopusauthoridBarnett, HJM=7103012300en_HK

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