Characteristics and outcomes of large artery occlusion-related stroke due to intracranial atherostenosis: An experience from a single center in Saudi Arabia.

Autor:	Zafar AS; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Shahid R; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Albakr AI; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Aljaafari DT; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alkhamis FA; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Shariff EM; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alabdali MM; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Nazish S; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alshamrani FJG; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alamri AS; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Hadhiah KM; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alsulaiman AA; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alkhaldi NA; Department of Neurology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Al-Suhibani SS; Department of Radiology, College of Medicine and King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Al-Jehani HM; Department of Neurosurgery, Critical Care Medicine and Interventional Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Journal of family & community medicine [J Family Community Med] 2024 Apr-Jun; Vol. 31 (2), pp. 140-147. Date of Electronic Publication: 2024 Apr 15.
DOI:	10.4103/jfcm.jfcm_313_23
Abstrakt:	Background: Literature on the frequency, response to treatment, and outcomes of acute ischemic stroke (AIS) due to intracranial atherostenosis (ICAS)-related intracranial large artery occlusion (ILAO) from Saudi Arabia is scarce. The aim of this study was to identify the percentage, describe the characteristics, and observe the treatment response in patients with AIS attributed to ICAS-related ILAO. Materials and Methods: This cross-sectional study included all adult patients from 2017-2021 who fulfilled the inclusion criteria for the diagnosis of ICAS-related AIS. Patients were dichotomized based on ILAO. Mortality and functional outcomes (FOCs) based on 90 days' dependence level were compared between the two groups. The association between ILAO and other variables was assessed using the Chi-squared test, odds ratios (OR), and 95% confidence interval (CI). Results: ILAO was found in 38.7% of patients with ICAS-related AIS. Men comprised three-fourths of the cohort and were more frequent in the ILAO group. Smoking was associated with increased ( P = 0.04) likelihood of ILAO. Patients with ILAO had more severe strokes ( P ≤ 0.001) than patients without. Middle cerebral artery was the most common occluded vessel (52%). Functional dependence ( P = 0.003, OR = 2.87, CI = 1.42-5.77), malignant transformation ( P = 0.001, OR = 8.0, CI = 1.82-35.9), and mortality ( P ≤ 0.001, OR = 7.67, CI = 2.40-24.5) were significantly higher among ILAO group. Patients with ILAO with unfavorable FOC were older than those who achieved better FOC ( P ≤ 0.001). Thrombolysis ( P = 0.02, OR = 2.50, CI = 1.15-5.41) and mechanical thrombectomy (MT) improved FOC in patients with ILAO ( P = 0.04, OR = 2.33, CI = 1.10-4.92). Conclusion: ILAO is common in patients with ICAS-related AIS. Timely hyperacute stroke treatment can help improve the FOC of otherwise disabling stroke due to ILAO. Raising awareness of the community about stroke is needed, so that a higher number of patients can arrive at hospital within the golden hours. Further data from the region are required to recognize the efficacy of MT in ICAS-related ILAO. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Journal of Family and Community Medicine.)
Databáze:	MEDLINE
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