Blood flow may be an important factor affecting lesion size and pattern because it can influence the activation of platelets and the coagulation cascade and dislodge thrombi. These risk factors, however, have not been associated with the distribution and size of these ischemic lesions. Thromboembolism due to rupture of ulcerative plaque as well as the degree of stenosis has been especially associated with ischemic stroke in these patients. A wide CCA-ICA angle is associated with low-body plaque of the carotid artery.Ītherosclerosis of the carotid artery is one of the major causes of ischemic stroke, with artery-to-artery embolism being the major stroke mechanism in patients with atherosclerosis of the carotid artery. Low-body plaques are more frequently associated with small scattered lesions, whereas high-apical plaques are more frequently associated with large lesions having additional lesions. The presence of low-body plaques (odds ratio: 3.106, 95% confidence interval: 1.105–8.728, p = 0.032) was independently associated with the small lesion-only pattern. 32.3%, p = 0.040), whereas high-apical plaques were more frequently associated with large lesions having additional lesions (38.7% vs. Low-body plaques were more frequently associated with small scattered or cortical lesions (54.8% vs. Hyperlipidemia was more prevalent and the common carotid artery (CCA)-ICA angle was wider (167.7 ± 10.4° vs 162.3 ± 9.8°, p = 0.019) in patients with low-body than high-apical plaques. Of the 93 acute ischemic stroke patients enrolled, 31 had high-apical and 62 had low-body plaques. Factors associated with plaque location and lesion pattern, dichotomized by size, were investigated. The geometric parameters of the ICA (angles between arteries) were measured, and ischemic lesion patterns were classified according to the number, location, and size of the lesions. The carotid plaque location was divided into high-apical and low-body types. Ischemic stroke patients with symptomatic proximal ICA disease (> 50% diameter stenosis) were enrolled. This study hypothesized that the atherosclerotic ICA geometry and plaque location would be associated with lesion pattern in patients with acute ischemic stroke. Artery-to-artery embolism is the major stroke mechanism in patients with atherosclerotic carotid disease. Atherosclerosis of the internal carotid artery (ICA) is an important cause of ischemic stroke.
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