Relation Between Syntax Score and Complexity of Carotid Artery Disease

Year 2021, , 555 - 559, 31.07.2021

Mehtap Erdoğan , Ramazan Akdemir , Mehmet Bülent Vatan

https://doi.org/10.16899/jcm.904471

Abstract

Introduction: Carotid artery disease may cause severe constriction or complete occlusion in carotid arteries, it may not give any symptoms until it appears. In some people, stroke is the first finding of the disease. One of the most important causes of stroke is carotid artery stenosis and atherosclerosis causes a total of one third of the stroke.
Atherosclerosis; It is a specific finding of both coronary and carotid artery disease.The relationship between carotid atherosclerotic diasease and coronary artery disease (CAD) have been in previous reports
Aim: In this study, we aimed to show the relationship between the severity of the carotid artery stenosis(CAS) determined by angiography and the anatomical complexity of CAD assessed by SYNTAX Score (SS).
Material and Methods: Our study was carried out in accordance with the Declaration of Helsinki Principles by obtaining the ethics committee approval dated 09.06.17 and numbered E.8640.
A total of 45 patients with simultaneously carotid and coronary angiography performed were included in our study. SS, a marker of CAD complexity, was determined by dedicated computer software. The patients were divided into two groups according to the classification of SS: low SS (n=33, SS <22) and intermediate-high SS (n=12, SS ≥22) groups. The severity of CAS was assessed by digital subtraction angiography (DSA) of six distinct segments of the carotid artery included the left and right common, internal, and external carotid arteries. Spearman’s correlation coefficients were used to determine the correlations between SS and CAS score.
Results:
The CAS severity score was significantly higher in patients with intermediate and high SS group than in the low SS group (3/4/4.75 vs. 1/2/3, p=0.001). There was also significant correlation between SS and CAS severity score (r=0.47, p=0.001).
Conclusions:
We revealed that there was a proportional increase in the severity of CAS to CAD complexity using SS. It may suggest that complex multivascular atherosclerotic disease is the systemic nature of atherosclerosis.

Keywords

Carotis Artery Stenosis, Coronary Artery Disease, Constriction, Stroke, SyntaxScore

Karotis Arter Hastalığı Şiddeti ile Syntax Skoru Arasındaki İlişki

Abstract

Giriş: Karotis arter hastalığı, karotis arterlerde şiddetli daralmaya veya tam tıkanmaya neden olabilir, ortaya çıkana kadar herhangi bir belirti vermeyebilir. Bazı kişilerde, hastalığın ilk bulgusu inmedir. İnmelerin en önemli nedenlerinden biri karotis arter stenozudur (KAS) ve toplam inmelerin üçte birine atheroskleroz neden olur.
Atheroskleroz; hem koroner ve hem de karotis arter hastalığının spesifik bulgusudur. Aterosklerotik karotis hastalığı ile koroner arter hastalığı (KAH) arasındaki ilişki önceki çalışmalarda gösterilmiştir.
Amaç: Bu çalışmada anjiyografi ile değerlendirilen karotis arter darlığının şiddeti ile SYNTAX Skoru (SS) ile değerlendirilen KAH' nın anatomik kompleksliği arasındaki ilişkiyi göstermeyi amaçladık.
Materyal Metod: Çalışmamız 09.06.17 tarih ve E.8640 sayılı etik kurul onayı alınarak, Helsinki İlkeler Deklarasyonu’na uygun olarak gerçekleştirilmiştir.
Çalışmamıza eş zamanlı olarak karotis ve koroner anjiyografi yapılan toplam 45 hasta dahil edildi. KAH kompleksliliği özel bir bilgisayar yazılımı olan SS ile belirlendi. Hastalar SS sınıflamasına göre iki gruba ayrıldı: düşük SS (n = 33, SS <22) ve orta-yüksek SS (n = 12, SS ≥22) grupları. KAS şiddeti, karotis arterlerin sol ve sağ carotis communis, internal ve external bölümlerini içeren altı farklı segmentinin dijital subtraksiyon anjiyografisi (DSA) ile değerlendirildi. SS ile KAS şiddeti arasındaki korelasyonları tespit etmek için Spearman korelasyon katsayıları kullanıldı.
Bulgular: KAS, orta ve yüksek SS grubunda, düşük SS grubuna göre anlamlı derecede yüksekti (3/4/4.75 vs. 1/2/3, p=0.001). SS ve KAD ciddiyeti arasında anlamlı korelasyon vardı (r=0.47, p=0.001).
Sonuç: Çalışmamız ile SS kullanarak KAD ile KAS şiddetinde orantılı bir artış olduğunu gösterildi. Karmaşık multivasküler aterosklerotik hastalığın, aterosklerozun sistemik doğası olduğunu düşündürebilir.

Keywords

Karotis Arter Darlığı, Koroner Arter Hastalığı, Konstriksiyon, İnme, Syntaks Skoru

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