Carotid Artery Stenosis Is Uncommon As A Cause Of Stroke In Saudi Population

Objective: To determine the frequency and outcome of significant carotid artery disease in patients admitted to stroke unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Background: Carotid artery disease (CAD) is known to be a significant cause of ischemic stroke, with as many as 22% strokes attributable to CAD. The prevalence and outcomes of CAD are not known in Saudi population. Design/Methods: After IRB approval, all patients admitted with ischemic stroke between January 2014 and December 2015 were identified. Frequency of significant CAD was determined from radiological data; outcomes were determined clinically and radiologically. Results: A total of 435 patients were included. There were 273 men (62.8%) and 162 women (37.2%) with mean age of 57.4 +/−12.2 years. Significant CAD was found in 48 vessels in 40 (9.2%) patients, of which 30 were symptomatic. Traditional stroke risk factors including male gender, hypertension, diabetes, smoking, dyslipidemia and prior stroke were similar in patients with and without significant CAD. Obesity, however, was inversely proportional to significant carotid artery disease (p = 0.009). Out of the 30 symptomatic vessels, 9 were treated with carotid artery stenting, 1 had endarterectomy, and 3 had urgent thrombectomy without stenting. 17 symptomatic vessels were not treated because of patient/family refusal (2 cases), contraindication to intervention (5 cases), and complete occlusion (10 cases). One (7.7%) of the 13 treated patients had ipsilateral stroke on follow up, and one (7.7%) had contralateral TIA, 9 had no recurrence, while no clinical data was available on 2. Among the untreated 17 vessels, one (5.9%) had ipsilateral stroke, 7 (41.2%) had no recurrence and 9 (52.9%) were lost to follow up. Conclusions: Carotid artery disease was an uncommon cause of stroke in our cohort of Saudi population. Only a small number of patients underwent carotid intervention. Obesity appeared to be protective against significant carotid artery disease. Study Supported by: The authors acknowledge the help of Mr. Fahad AlSaawi and Dr. Alaa AlThubaiti for their help in this work. Disclosure: Dr. Shaheen has nothing to disclose. Dr. AlBelali has nothing to disclose. Dr. AlSaqabi has nothing to disclose. Dr. AlAskar has nothing to disclose. Dr. AlKanhal has nothing to disclose. Dr. AlTurki has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Khatri has nothing to disclose.