Investigation of A new anatomical scoring method in the selection of revascularization and interventional treatment in the carotid artery

SUMMARY Investigation of A New Anatomical Scoring Method In The Selection of Revascularization And Interventional Treatment In The Carotid Artery INTRODUCTION AND AIM: 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. Coronary and carotid artery disease are both known to be spesific manifestations of atherosclerosis. The relationship between carotid atherosclerotic diasease and coronary artery disease (CAS) have shown in previous reports. However the association between complex CAD assessed by Syntax Score (SxScore) and severity of carotid artery stenosis (CAS) has not been fully investigated.In this study, we aimed to investigate the relationship between the severity of CAD anatomical stenosis determined by an angiography and the anatomical complexity of CAD with SxScore. MATERIALS AND METHOD: A total of 45 patients with concurrent carotid and coronary angiography were included. CAD complexity was determined using SxScore using special computer software. Patients were divided into two groups according to the SxScore classification as low SxScore (n = 33, SxScore <22) and medium-high SxScore (n = 12, SxScore ≥22) groups. The severity of CAD was assessed by digital subtraction angiography (DSA) consisting of six separate sections, including the left and right common carotid artery, internal and external carotid arteries.Spearman correlation coefficients were used to determine correlations between SxScore and CAD severity. RESULTS: The severity of CAD was significantly higher in the moderate and high SxScore groups than the low SxScore group (3/4/4 to 75/1/2/3, p = 0.001). Significant correlation was also found between SxScore and CAD severity (r = 0.47, p = 0.001). CONCLUSION: This study revealed that there is a direct proportionate increase in the severity of CAD and the anatomic CAD complexity assessed using SxScore. The complex multivascular atherosclerotic disease may be suggested as systemic nature of atherosclerosis. Key Words: Carotid Artery Stenosis, Constriction, Stroke, CoronaryArtery Disease, Syntaks Score.