Studies looking at the long-term impact of treatments to reduce the narrowing of the arteries in the neck
Narrowing (stenosis) of the carotid arteries or vertebral arteries account for a fifth of all strokes and transient ischaemic attacks (TIAs). There are various procedures that can remove the blockage, including surgical removal.
One of the treatment options for carotid stenosis is ‘endarcterectomy’. This is a surgical procedure in which a surgeon cuts open the artery, and removes the atherosclerotic plaque (revascularisation).
In addition, we also look for small structural changes in the heart, which can either be present from birth or develop later in life, which can also cause clots to form. These can be seen by a simple ultrasound scan of the heart, called an echocardiogram.
Patients can also undergo an R test, which involves wearing a lightweight monitor around the neck; this records heart rate and rhythm while they carry out everyday activities.
The recordings from the R test are then reviewed to identify the presence, length and frequency of any episodes of atrial fibrillation (AF) and any abnormalities seen on the echocardiogram.
From this information we can answer questions such as:
- what is the short- and long-term risk of recurrent stroke in patients who had brief paroxysmal AF (pAF) on 5-day monitoring?
- do very brief episodes of pAF progress to longer episodes over time?
- can the progression of pAF to permanent AF be predicted from the results of the echocardiogram?
These projects are coordinated by the Centre for the Prevention of Stroke and Dementia www.stroke.ox.ac.uk