Extracranial Carotid Artery Stenosis Among Ischemic Stroke and Transient Ischemic Attack Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study

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Date

2025-07

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Addis Ababa University

Abstract

Background: Carotid artery stenosis, a common large artery disease caused by atherosclerosis, can lead to ischemic stroke or TIA. Early revascularization in severe cases significantly lowers the risk of recurrent stroke. Although well-studied in developed countries, data from developing regions are scarce. This study aimed to assess the prevalence and associated factors of carotid artery stenosis among ischemic stroke patients, as no prior research has been conducted in our country Objective: To assess clinical profile, prevalence and corelated factors associated with extra cranial carotid artery stenosis among ischemic stroke and TIA patients. Methods: A cross-sectional study was conducted at a single tertiary hospital on 186 patients with ischemic stroke and transient ischemic attack (TIA) who were either being followed at the neurology referral clinic or newly admitted to the hyperacute stroke unit between November 1, 2024, and April 30, 2025. All patients who underwent carotid Doppler ultrasonography were included. Data on demographic characteristics and vascular risk factors were collected. Carotid Doppler ultrasound findings, including the degree of stenosis and the anatomical distribution of lesions in the extracranial carotid arteries, were recorded. Results: The prevalence of significant extra cranial CAS among ischemic stroke and TIA patients was 21.5% with the internal carotid artery (67.5%) being the most frequently affected site in our study. Moderate stenosis (50–69%) was the most frequently observed, particularly in unilateral cases, which accounted for 80% of the total. Patients with significant CAS were slightly older and more often female. Multivariable analysis identified female sex (AOR = 0.339; 95% CI: 0.139–0.800; p = 0.020), hypertension (AOR = 3.458; 95% CI: 1.304–9.421; p = 0.014), and dyslipidemia (AOR = 6.789; 95% CI: 2.017–22.848; p = 0.004 as significant predictors of CAS. Conclusion: This study highlights a substantial burden of significant extra cranial carotid artery stenosis (CAS) among ischemic stroke and TIA patients in a developing country setting, emphasizing the importance of routine carotid screening. Identifying high-risk groups can guide targeted prevention and timely intervention, potentially reducing recurrent stroke through appropriate management such as revascularization.

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Carotid artery stenosis

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