Abstract
Current terminology for clinical episodes relating to stroke is inconsistent and unclear, does not permit inclusion of data regarding the location and magnitude of extracranial and intracerebral arterial disease, does not coincide with existing classifications in Europe, and characterizes a hemispheric entity only, as opposed to a global description including prior symptoms in both hemispheres. A new classification system (CHAT) has been designed to deal with these problems, including the current clinical presentation, historical clinical episodes, the site and pathologic type of arterial disease, and information regarding abnormalities of the brain. Using this system, a retrospective review of 480 consecutive carotid endarterectomies is presented, demonstrating the advantages of the CHAT classification. Data include a significant difference in the probability of survival after carotid endarterectomy for asymptomatic stenosis in patients with prior symptoms on the opposite side, as well as a significant difference in the probability of stroke-free survival between patients with amaurosis fugax and those with prior carotid cortical symptoms (TIAs) as the presenting clinical condition. The CHAT classification is suggested as a significant advance in the reporting of all surgical cerebrovascular disease experience, and has particular implications for the current randomized trials between medical and surgical therapy for carotid artery disease.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- A classification and outline of cerebrovascular diseases. II. Stroke. 1975 Sep-Oct;6(5):564–616. doi: 10.1161/01.str.6.5.564. [DOI] [PubMed] [Google Scholar]
- Courbier R. Basis for an international classification of cerebral arterial diseases. J Vasc Surg. 1986 Aug;4(2):179–183. doi: 10.1067/mva.1986.avs0040179. [DOI] [PubMed] [Google Scholar]
- GEHAN E. A. A GENERALIZED WILCOXON TEST FOR COMPARING ARBITRARILY SINGLY-CENSORED SAMPLES. Biometrika. 1965 Jun;52:203–223. [PubMed] [Google Scholar]
- WHISNANT J. P., SIEKERT R. G., MILLIKAN C. H. Appraisal of the current trend toward surgical treatment of occlusive cerebrovascular disease. Med Clin North Am. 1960 Jul;44:875–886. doi: 10.1016/s0025-7125(16)33975-x. [DOI] [PubMed] [Google Scholar]