The smartphone comes close to the neck. The video starts. The expert receives the registration and evaluates it carefully. If there is something wrong with the flow of blood through the carotids, arteries that carry blood to the brain, he decides to proceed with more thorough tests. In the future, perhaps, the screening ofischemic stroke (i.e. linked to the lack of blood supply to an area of the brain, a form that represents at least 80% of cases of cerebral ischemia), it could also pass through the mobile phone. What makes him think are the results of an original research coordinated by the interventional cardiologist Hsien-Li Kaoof the Taiwan National University Hospital in Taipei.
Up to 5% of strokes in people without clear symptoms
The study is published in the Journal of American Heart Association and fixes attention on the carotids, the two arteries that run along the sides of the neck immediately under the skin. To give the scholars the cue there is a fact that is reported by the cardiologist himself: tools are needed that allow to identify more precisely who risks the insufficient supply of blood and oxygen to the brain tissue, given that every year between 2 and 5% of ischemic strokes are seen in people who do not show clear symptoms.
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How the test is carried out
The study involved a population of 202 people, with an average age of 68, mostly males. Just over half of the participants had significant carotid artery stenosis, so they had an obstruction equal to at least 50% of the vessel caliber already seen with ultrasound. 46% of the participants, on the other hand, did not have significant shrinkage. Participants in the study, performed in the pre-Covid era, were studied with a very simple test. They lay on their back, with their heads tilted back inside a special “box” that prevented any movement of the head. Then an older generation smartphone was mounted on the box itself, also to facilitate screening by the majority of the population for a possible widespread use, to record for 30 seconds what happened along the person’s neck.
Screening is quite reliable
Analyzing with a particular algorithm what emerged from the video, the scholars have seen that an accuracy rate of 87% was reached in subjects who had carotid stenosis. Obviously, standard echo Doppler examinations were carried out (to detect not only the conformation of the walls and the presence of any narrowing along the vessels but also to observe the flow of blood inside them) to confirm what was observed. Although the study population is very small and is at high cardiovascular risk (not to mention neck size that could skew the data), this population survey strategy could prove very useful in the future.
Non-invasive and easy to perform examination
“Existing diagnostic methods – ultrasound, CT and MRI – require screening with specialized medical imaging equipment and personnel – is Kao’s comment. The analysis of videos recorded on a smartphone is non-invasive and easy to perform, so it may offer the opportunity to increase screening. While more research and development is required, motion recording and analysis could be implemented remotely or a downloadable app could also be possible. ”
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Other confirmations needed
“The technique is interesting as a mass screening method, because it seems fast and non-invasive, as on the other hand is the ultrasound Doppler – says Massimo Del Sette, Director of Neurology of the San Martino Polyclinic in Genoa. However, as with all screening techniques, it is necessary to carefully evaluate the risk of both “false positives”, that is, of subjects who seem to have a stenosis which then proves not to be such in more precise tests, and of “false negatives”, that is subjects in which the presence of stenosis escapes examination. Since we already have low-cost non-invasive methods available, this interesting innovation could be interesting not so much for the diagnosis of stenosis, but as a “monitoring” technique over time of the evolution of the stenosis itself “.
Early diagnosis can save
The important thing, in any case, is to remember that the early diagnosis of any plaques on the carotid arteries is essential to implement targeted prevention and control strategies. In fact, it should not be forgotten that carotid stenosis alone accounts for about one fifth of the total causes of ischemic stroke. “The identification of the strictures allows to start the correct prevention, which basically consists of medical therapies (antiplatelet drugs, antihypertensives, statins or other drugs that can lower the levels of” bad “cholesterol) – says Del Sette. In selected cases, especially in the presence of carotid stenosis that have already caused symptoms, it is also possible to resort to surgical or interventional neuroradiology therapies, or rather to stents “.
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