10. Stroke: a comprehensive overview of trends, prevention, and treatment (literature review)
DOI:
https://doi.org/10.35805/BSK2024III010Downloads
Abstract
A stroke is an emergency medical condition, commonly referred to as a cerebrovascular accident, occurs when the blood supply to the brain is interrupted, depriving brain tissue of oxygen and essential nutrients. This interruption can lead to rapid neurological impairment and, if not treated promptly, permanent brain damage or even death. Stroke is primarily categorized into two types: ischemic, resulting from arterial blockage, and hemorrhagic, caused by a ruptured blood vessel. Conditions such as acute cerebral circulatory disorder, atherosclerosis, and carotid artery stenosis are strongly associated with an increased stroke risk. Understanding these underlying factors is crucial for effective prevention, early detection, and management of stroke. Globally, stroke ranks as the second lead in cause of disability and mortality, disproportion at early affecting low-and-middle - income countries. Efforts in stroke prevention emphasizes the significance of early detection, management, promoting healthy lifestyles, and implementing legislative measures. The healthcare costs associated with stroke are substantial and projected to grow significantly. Socioeconomic factors and adverse working conditions also influence stroke incidence. Advancements in surgical revascularization techniques, such as carotid endarterectomy and stenting, have demonstrated efficacy in reducing stroke risk. Continuous research and development of optimal treatment strategies and monitoring protocols are essential for improving stroke outcomes and mitigating its global burden.
Keywords
stroke, acute cerebral circulatory disorder, carotid endarterectomy, carotid artery stenting, atherosclerosis
References
- Feske SK. Ischemic Stroke. Am J Med. Dec 2021;134(12):1457-1464. doi:10.1016/j.amjmed.2021.07.027
- Sarmah D, Datta A, Raut S, et al. The Role of Inflammasomes in Athero-sclerosis and Stroke Pathogenesis. Curr Pharm Des. 2020;26(34):4234-4245. doi:10.2174/1381612826666200427084949
- Gusev E, Sarapultsev A. Atheroscle-rosis and Inflammation: Insights from the Theory of General Patholog-ical Processes. Int J Mol Sci. Apr 26 2023;24(9) doi:10.3390/ijms24097910
- Yoshida K, Miyamoto S. Evidence for management of carotid artery stenosis. Neurol Med Chir (Tokyo). 2015;55(3):230-40. doi:10.2176/nmc.ra.2014-0361
- Saini V, Guada L, Yavagal DR. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interven-tions. Neurology. Nov 16 2021;97(20 Suppl 2):S6-S16. doi:10.1212/WNL.0000000000012781
- Kjeldsen SE, Narkiewicz K, Burnier M, Oparil S. The Global Burden of Disease Study 2015 and Blood Pres-sure. Blood Press. Feb 2017;26(1):1. doi:10.1080/08037051.2016.1267557
- Ignatyeva VI, Voznyuk IA, Shamalov NA, Reznik AV, Vinitskiy AA, Derk-ach EV. [Social and economic bur-den of stroke in Russian Federa-tion]. Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8. Vyp. 2):5-15. Sotsial'no-ekonomicheskoe bre-mya insul'ta v Rossiiskoi Federatsii. doi:10.17116/jnevro20231230825
- Suslina ZA, Piradov MA, Domashen-ko MA. [Stroke: the review of the problem (15 years after)]. Zh Nev-rol Psikhiatr Im S S Korsakova. 2014;114(11):5-13
- Markabayeva A, Bauer S, Pivina L, et al. Increased prevalence of essential hypertension in areas previously ex-posed to fallout due to nuclear weap-ons testing at the Semipalatinsk Test Site, Kazakhstan. Environ Res. Nov 2018;167:129-135. doi:10.1016/j.en-vres.2018.07.016
- Zhakhina G, Zhalmagambetov B, Gusmanov A, et al. Incidence and mortality rates of strokes in Ka-zakhstan in 2014-2019. Sci Rep. Sep 26 2022;12(1):16041. doi:10.1038/s41598-022-20302-8
- Writing Group M, Mozaffarian D, Benjamin EJ, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. Jan 26 2016;133(4):e38-360. doi:10.1161/CIR.0000000000000350
- Arnalich-Montiel A, Burgos-Santam-aria A, Pazo-Sayos L, Quintana-Villa-mandos B. Comprehensive Manage-ment of Stroke: From Mechanisms to Therapeutic Approaches. Int J Mol Sci. May 11 2024;25(10) doi:10.3390/ijms25105252
- Reinhard M, Schwarzer G, Briel M, et al. Cerebrovascular reactivity predicts stroke in high-grade carot-id artery disease. Neurology. Oct 14 2014;83(16):1424-31. doi:10.1212/WNL.0000000000000888
- Zheng B, Luo Y, Li Y, et al. Prevalence and risk factors of stroke in high-al-titude areas: a systematic review and meta-analysis. BMJ Open. Sep 21 2023;13(9):e071433. doi:10.1136/bmjopen-2022-071433
- Koton S, Pike JR, Johansen M, et al. Association of Ischemic Stroke Inci-dence, Severity, and Recurrence With Dementia in the Atherosclerosis Risk in Communities Cohort Study. JAMA Neurol. Mar 1 2022;79(3):271-280. doi:10.1001/jamaneurol.2021.5080
- Libby P. The changing land-scape of atherosclerosis. Na-ture. Apr 2021;592(7855):524-533. doi:10.1038/s41586-021-03392-8
- Chow YL, Teh LK, Chyi LH, Lim LF, Yee CC, Wei LK. Lipid Metabolism Genes in Stroke Pathogenesis: The Atherosclerosis. Curr Pharm Des. 2020;26(34):4261-4271. doi:10.2174/1381612826666200614180958
- Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and ath-erosclerosis: signaling pathways and therapeutic intervention. Signal Trans-duct Target Ther. Apr 22 2022;7(1):131. doi:10.1038/s41392-022-00955-7
- Zhu Y, Xian X, Wang Z, et al. Re-search Progress on the Relation-ship between Atherosclerosis and Inflammation. Biomolecules. Aug 23 2018;8(3) doi:10.3390/biom8030080
- Chan YH, Ramji DP. Key Roles of Inflam-mation in Atherosclerosis: Mediators Involved in Orchestrating the Inflam-matory Response and Its Resolution in the Disease Along with Therapeu-tic Avenues Targeting Inflammation. Methods Mol Biol. 2022;2419:21-37. doi:10.1007/978-1-0716-1924-7_221.vonVietinghoffS,KoltsovaEK.In-flammationinatherosclerosis:Akeyroleforcytokines.Cytokine.Oct2019;122:154819.doi:10.1016/j.cyto.2019.154819
- Tabas I, Bornfeldt KE. Macrophage Phenotype and Function in Differ-ent Stages of Atherosclerosis. Circ
- He C, Kim HI, Park J, Guo J, Huang W. The role of immune cells in dif-ferent stages of atherosclerosis. Int J Med Sci. 2024;21(6):1129-1143. doi:10.7150/ijms.94570
- Choi SH, Gonen A, Diehl CJ, et al. SYK regulates macrophage MHC-II expression via activation of autopha-gy in response to oxidized LDL. Auto-phagy. 2015;11(5):785-95. doi:10.1080/15548627.2015.1037061
- Morris DR, Ayabe K, Inoue T, et al. Evidence-Based Carotid Interven-tions for Stroke Prevention: State-of-the-art Review. J Atheroscler Thromb. Apr 3 2017;24(4):373-387. doi:10.5551/jat.38745
- Oliveira TF, Centellas CDR, Dalio MB, Joviliano EE. Short term outcomes of carotid surgery: the real-world experience of a single teaching cen-ter. J Vasc Bras. 2024;23:e20230033. doi:10.1590/1677-5449.202300332
- Ferrero E, Ferri M, Viazzo A, et al. A retrospective study on early carot-id endarterectomy within 48 hours after transient ischemic attack and stroke in evolution. Ann Vasc Surg. Jan 2014;28(1):227-38. doi:10.1016/j.avsg.2013.02.015
- Go AS, Mozaffarian D, Roger VL, et al. Executive summary: heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. Jan 21 2014;129(3):399-410. doi:10.1161/01.cir.0000442015.53336.12
- Jalbert JJ, Nguyen LL, Gerhard-Her-man MD, et al. Comparative Effec-tiveness of Carotid Artery Stenting Versus Carotid Endarterectomy Among Medicare Beneficiaries. Circ Cardiovasc Qual Outcomes. May 2016;9(3):275-85. doi:10.1161/CIR-COUTCOMES.115.002336
- Kim LK, Yang DC, Swaminathan RV, et al. Comparison of trends and out-comes of carotid artery stenting and endarterectomy in the United States, 2001 to
- Al-Damluji MS, Dharmarajan K, Zhang W, et al. Readmissions after carotid artery revascularization in the Medicare population. J Am Coll Cardiol. Apr 14 2015;65(14):1398-408. doi:10.1016/j.jacc.2015.01.048
- Mokin M, Rojas H, Levy EI. Random-ized trials of endovascular therapy for stroke--impact on stroke care. Nat Rev Neurol. Feb 2016;12(2):86-94. doi:10.1038/nrneurol.2015.240
- Shimamura N, Fumoto T, Naraoka M, et al. Irreversible Neuronal Damage Begins Just After Aneurysm Rupture in Poor-Grade Subarachnoid Hem-orrhage Patients. Transl Stroke Res. Oct 2021;12(5):785-790. doi:10.1007/s12975-020-00875-0
- Colak Z, Borojevic M, Bogovic A, Iv-ancan V, Biocina B, Majeric-Kogler V. Influence of intraoperative cere-bral oximetry monitoring on neu-rocognitive function after coronary artery bypass surgery: a random-ized, prospective study. Eur J Cardio-thorac Surg. Mar 2015;47(3):447-54. doi:10.1093/ejcts/ezu193
- Lal BK, Roubin GS, Jones M, et al. Influence of multiple stents on periprocedural stroke after carotid artery stenting in the Carotid Revas-cularization Endarterectomy versus Stent Trial (CREST). J Vasc Surg. Mar 2019;69(3):800-806. doi:10.1016/j.jvs.2018.06.221
- Mazzaccaro D, Nano G. Regarding "Updated Society for Vascular Sur-gery guidelines for management of extracranial carotid disease". J Vasc Surg. Mar 2018;67(3):993-994. doi:10.1016/j.jvs.2017.09.027
- Singh RJ, Chen S, Ganesh A, Hill MD. Long-term neurological, vascular, and mortality outcomes after stroke. Int J Stroke. Oct 2018;13(8):787-796. doi:10.1177/1747493018798526
- Moran AE, Roth GA, Narula J, Men-sah GA. 1990-2010 global cardio-vascular disease atlas. Glob Heart. Mar 2014;9(1):3-16. doi:10.1016/j.gheart.2014.03.1220
- Andersson J, Rejno A, Jakobsson S, Hansson PO, Nielsen SJ, Bjorck L. Symptoms at stroke onset as de-scribed by patients: a qualitative study. BMC Neurol. May 3 2024;24(1):150. doi:10.1186/s12883-024-03658-4
- Carvalho V, Cruz VT. Clinical presen-tation of vertebrobasilar stroke. Por-to Biomed J. Nov-Dec 2020;5(6):e096
- Shutze W, Gierman J, McQuade K, Pearl G, Smith B. Treatment of proximal vertebral artery disease. Vascular. Apr 2014;22(2):85-92. doi:10.1177/1708538112473966
- Amin-Hanjani S, Stapleton CJ, Du X, et al. Hypoperfusion Symptoms Poorly Predict Hemodynamic Com-promise and Stroke Risk in Ver-tebrobasilar Disease. Stroke. Feb 2019;50(2):495-497. doi:10.1161/STROKEAHA.118.023101
- Zhao K, Yan P, Wang X, et al. A ret-rospective study of drug-coated bal-loon angioplasty for vertebral artery origin stenosis. Neuroradiology. Aug 2022;64(8):1617-1625. doi:10.1007/s00234-022-02926-9
- Xu R, Zhang X, Liu S, et al. Percu-taneous transluminal angioplas-ty and stenting for vertebral artery stenosis. Cochrane Database Syst Rev. May 17 2022;5(5):CD013692. doi:10.1002/14651858.CD013692.pub2
- Burle VS, Panjwani A, Mandalaneni K, Kollu S, Gorantla VR. Vertebral Artery Stenosis: A Narrative Review. Cureus. Aug 2022;14(8):e28068. doi:10.7759/cureus.28068
- Johansson E, Cuadrado-Godia E, Hayden D, et al. Recurrent stroke in symptomatic carotid steno-sis awaiting revascularization: A pooled analysis. Neurology. Feb 9 2016;86(6):498-504. doi:10.1212/WNL.0000000000002354
- Bonati LH, Ederle J, Dobson J, et al. Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in pa-tients randomized to endovascular treatment or endarterectomy. Int J Stroke. Apr 2014;9(3):297-305. doi:10.1111/ijs.12084
- Compter A, van der Worp HB, Schonewille WJ, et al. Stenting ver-sus medical treatment in patients with symptomatic vertebral artery stenosis: a randomised open-la-bel phase 2 trial. Lancet Neurol. Jun 2015;14(6):606-14. doi:10.1016/S1474-4422(15)00017-4
- Feng H, Xie Y, Mei B, et al. Endovas-cular vs. medical therapy in symp-tomatic vertebral artery stenosis: a meta-analysis. J Neurol. May 2017;264(5):829-838. doi:10.1007/s00415-016-8267-0
- Markus HS, Harshfield EL, Compt-er A, et al. Stenting for symptomat-ic vertebral artery stenosis: a pre-planned pooled individual patient data analysis. Lancet Neurol. Jul 2019;18(7):666-673. doi:10.1016/S1474-4422(19)30149-8
- Markus HS, Larsson SC, Kuker W, et al. Stenting for symptomatic vertebral artery stenosis: The Vertebral Artery Ischaemia Stenting Trial. Neurolo-gy. Sep 19 2017;89(12):1229-1236. doi:10.1212/WNL.0000000000004385
- Gistera A, Hansson GK. The immu-nology of atherosclerosis. Nat Rev Nephrol. Jun 2017;13(6):368-380. doi:10.1038/nrneph.2017.51
- Liang P, Cronenwett JL, Secemsky EA, et al. Risk of Stroke, Death, and Myocardial Infarction Following Tran-scarotid Artery Revascularization vs Carotid Endarterectomy in Patients With Standard Surgical Risk. JAMA Neurol. May 1 2023;80(5):437-444. doi:10.1001/jamaneurol.2023.0285
- Naylor R, Rantner B, Ancetti S, et al. Editor's Choice - European So-ciety for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atheroscle-rotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg. Jan 2023;65(1):7-111. doi:10.1016/j.ejvs.2022.04.011
- Letsou GV, Musfee FI, Zhang Q, Loor G, Lee AD. Stroke and mortality rates after off-pump vs. pump-assisted/no-clamp coronary artery bypass graft-ing. J Cardiovasc Surg (Torino). Dec 2022;63(6):742-748. doi:10.23736/S0021-9509.22.12337-2
- Bandyk DF. Follow-up after ca-rotid endarterectomy and stent-ing: What to look for and why. Semin Vasc Surg. Dec 2020;33(3-4):47-53. doi:10.1053/j.semvasc-surg.2020.11.001
- Jacobsen AP, Raber I, McCarthy CP, et al. Lifelong Aspirin for All in the Secondary Prevention of Chronic Coronary Syndrome: Still Sacrosanct or Is Reappraisal Warranted? Cir-culation. Oct 20 2020;142(16):1579-1590. doi:10.1161/CIRCULATIONA-HA.120.045695