Plaque morphology in acute symptomatic intracranial atherosclerotic disease
| Autor: | Siu Hung Li, Li Wang, Sze Ho Ma, Kwok Fai Hui, Hing Lung Ip, Simon C.H. Yu, Ning Ma, Lisa Wing Chi Au, Karen Ma, Thomas W. Leung, Anne Chan, Xinyi Leng, Bonaventure Ip, Yuehua Pu, Vincent Mok, Wing Chi Fong, Yannie Soo, Jia Liu, Ka Sing Lawrence Wong, Alexander Y.L. Lau, Howan Leung, Michael Fu, Richard Li, Zhongrong Miao, Florence Fan, Xinying Zou |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry ICAD Atherosclerotic disease 030204 cardiovascular system & hematology medicine.disease Lesion load 03 medical and health sciences Psychiatry and Mental health Stenosis 0302 clinical medicine Rotational angiography Internal medicine Cerebrovascular Disease Ischaemic stroke Cardiology Surface contour Medicine Surgery Plaque morphology Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurology, Neurosurgery, and Psychiatry |
| ISSN: | 1468-330X 0022-3050 |
| Popis: | BackgroundIntracranial atherosclerotic disease (ICAD) is globally a major ischaemic stroke subtype with high recurrence. Understanding the morphology of symptomatic ICAD plaques, largely unknown by far, may help identify vulnerable lesions prone to relapse.MethodsWe prospectively recruited patients with acute ischaemic stroke or transient ischaemic attack attributed to high-grade ICAD (60%–99% stenosis). Plaque morphological parameters were assessed in three-dimensional rotational angiography, including surface contour, luminal stenosis, plaque length/thickness, upstream shoulder angulation, axial/longitudinal plaque distribution and presence of adjoining branch atheromatous disease (BAD). We compared morphological features of smooth, irregular and ulcerative plaques and correlated them with cerebral ischaemic lesion load downstream in MRI.ResultsAmong 180 recruited patients (median age=60 years; 63.3% male; median stenosis=75%), plaque contour was smooth (51 (28.3%)), irregular (101 (56.1%)) or ulcerative (28 (15.6%)). Surface ulcers were mostly at proximal (46.4%) and middle one-third (35.7%) of the lesions. Most (84.4%) plaques were eccentric, and half had their maximum thickness over the distal end. Ulcerative lesions were thicker (medians 1.6 vs 1.3 mm; p=0.003), had steeper upstream shoulder angulation (56.2° vs 31.0°; pConclusionsUlcerative intracranial atherosclerotic plaques were associated with vulnerable morphological features and had a higher cumulative infarct load downstream. |
| Databáze: | OpenAIRE |
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