Prevalence and Calcification of Intracranial Arterial Stenotic Lesions as Assessed With Multidetector Computed Tomography Angiography
Autor: | Gerben J. J. Plas, S. Rozie, Philip J. Homburg, Aad van der Lugt, Diederik W.J. Dippel |
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Přispěvatelé: | Radiology & Nuclear Medicine, Neurology |
Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Population Blood Sedimentation Constriction Pathologic Asymptomatic Risk Factors Prevalence Humans Medicine Prospective Studies Registries Risk factor education Stroke Aged Aged 80 and over Advanced and Specialized Nursing education.field_of_study medicine.diagnostic_test business.industry Arterial stenosis Calcinosis Cerebral Arteries Middle Aged Intracranial Arteriosclerosis medicine.disease Cerebral Angiography Stenosis Cross-Sectional Studies Angiography cardiovascular system Female Neurology (clinical) Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Tomography Spiral Computed Cerebral angiography |
Zdroj: | Stroke, 42(5), 1244-1250. Lippincott Williams & Wilkins |
ISSN: | 1524-4628 0039-2499 |
Popis: | Background and Purpose— Intracranial arterial stenosis (ICAS) in patients with recent ischemic stroke is associated with a high risk of recurrent stroke. More insight into the pathophysiology of ICAS could help identify patients at high risk requiring more aggressive secondary prevention. We evaluated the prevalence, distribution, calcification, and the risk factors predisposing ICAS in a European stroke population. Methods— Consecutive patients with a transient ischemic attack or ischemic stroke (n=786) were evaluated for the presence and distribution of ICAS (≥30% luminal narrowing) by CT angiography. ICAS were categorized as symptomatic or asymptomatic, and the presence of calcification was assessed. The association of traditional cerebrovascular risk factors and the erythrocyte sedimentation rate with ICAS was analyzed. Results— In 178 of 786 patients (23%), 288 ICAS were observed. Most stenoses (n=194/288; 67%) were located in the posterior circulation arteries. In 59 of 786 patients (8%), ICAS were considered symptomatic. ICAS in the basilar artery and arteries beyond the circle of Willis were mainly noncalcified. In addition to age, gender, and several traditional cerebrovascular risk factors, erythrocyte sedimentation rate was independently associated with the presence of ICAS (OR, 1.20; 95% CI, 1.06–1.36) and with the presence of noncalcified ICAS in particular (OR, 1.20; 95% CI, 1.05–1.37). Conclusions— ICAS was observed in a noteworthy number of European stroke patients. Particularly, the majority of ICAS was observed in the posterior circulation, possibly conferring worse prognosis. ICAS in distal arteries were mainly noncalcified. Association of noncalcified ICAS and erythrocyte sedimentation rate may indicate a prominent role for inflammatory factors in intracranial atherosclerotic disease. |
Databáze: | OpenAIRE |
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