scholarly journals Risk Factors of Subacute Thrombosis After Intracranial Stenting for Symptomatic Intracranial Arterial Stenosis

Stroke ◽  
2017 ◽  
Vol 48 (3) ◽  
pp. 784-786 ◽  
Author(s):  
Xuan Sun ◽  
Xu Tong ◽  
Wai Ting Lo ◽  
Dapeng Mo ◽  
Feng Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Intracranial Stenting ◽  
Subacute Thrombosis

Abstract 82: Differences Between Caucasians and Asians in Intracranial Arterial Stenosis Among TIA and Minor Stroke Patients: Comparisons of Two Contemporary Cohorts

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Xinyi Leng ◽  
Robert Hurford ◽  
Xueyan Feng ◽  
Ka Lung Chan ◽  
Linxin Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ct Angiography ◽  
Interobserver Agreement ◽  
Arterial Stenosis ◽  
Minor Stroke ◽  
Intracranial Arterial Stenosis ◽  
Stroke Patients ◽  
Stroke Registry ◽  
The Difference ◽  
Ischemic Attack

Background: Despite numerous reports indicating ethnic difference in intracranial arterial stenosis (ICAS) between Caucasians and Asians, there has been no direct comparison in disease burden and clinical correlates of ICAS in stroke patients in the two populations with the same criteria to define ICAS. Methods: Acute minor stroke or transient ischemic attack patients who received cerebral MR/CT angiography exam in two cohorts were analyzed: Oxford Vascular Study (OXVASC, 2011-2018) with predominantly Caucasians, and the Chinese University of Hong Kong (CUHK) stroke registry (2011-2015) with predominantly Chinese. ICAS was defined as ≥50% stenosis in any major intracranial artery in MR/CT angiography. Interobserver agreement between 2 investigators for presence of ICAS was assessed in 50 cases with Cohen’s kappa. We compared the burden and risk factors of ICAS in the two cohorts. Results: Overall, 1,287 patients from OXVASC (mean age 69 years) and 640 from the CUHK cohort (mean age 66 years) were analyzed. Interobserver agreement for presence of ICAS was good (kappa=0.82). Prevalence of ICAS was significantly higher in Chinese than in Caucasians: 43.6% in the CUHK cohort versus 20.0% in OXVASC (crude OR 3.10; age-adjusted OR 3.81, 95% CI 3.06-4.75; p<0.001). Mean ages of patients with ICAS in the two cohorts were 75 and 68 years, respectively. The difference between Caucasians and Chinese in ICAS prevalence was smaller in those aged ≥70 years (28.1% versus 51.9%) than those <70 years (9.8% versus 38.0%) (Figure). ICAS shared similar risk factors in the two cohorts, including older age, and history of hypertension and diabetes. Conclusions: Chinese are more susceptible to ICAS, with an earlier onset age than Caucasians, but the ICAS burden in Caucasians was higher than previously estimated, especially in older patients.

scholarly journals Multiple Factor Analysis of Symptomatic Intracranial Arterial Stenosis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-89
Author(s):  
Chuanqiang Qu ◽  
Yuanyuan Zhao ◽  
Qinjian Sun ◽  
Yifeng Du
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Protective Factor ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Group A ◽  
Group B

Objective To discuss the correlation among intracranial arterial stenosis and its risk factors. Methods A total of 486 patients with transient ischemic attack (TIA) or ischemic cerebral infarction were examined using color doppler flow imaging (CDFI) and transcranial doppler ultrosonography (TCD). According to the degrees of extracranial arterial stenosis, patients with mild-to-moderate extracranial stenosis were classified into group A (435 cases) while those with constant severe stenosis or occlusion were classified into group B (51 cases). The differences between the two groups of risk factors were compared, and the multi-factor logistic regression analysis of risk factors associated with moderately severe intracranial arterial stenosis was performed. Results ① The risk factors that were significantly associated with intracranial arterial stenosis included age (P = 0.034) and gender (P = 0.044). ② Intracranial artery stenosis was observed in both anterior and posterior cerebral arteries in patients with hypertension, diabetes, and coronary heart disease respectively (P < 0.05). ③ Compared with group A, patients in group B were older (P = 0.000), with a higher proportion of men (P = 0.037), and the intracranial arterial stenosis degrees were significantly higher (P = 0.013). ④ Multi-factor logistic regression analysis showed that diabetes is a risk factor for moderately severe intracranial arterial stenosis (P < 0.05), and hyperlipidemia is a protective factor (P = 0.012). Conclusions Age, gender, hypertension, diabetes, coronary heart disease, and smoking are risk factors for the distribution of intracranial arterial stenosis. The degrees of intracranial arterial stenosis are related with extracranial arterial stenosis. Diabetes is a risk factor for moderately severe intracranial arterial stenosis while hyperlipidemia is a protective factor.

scholarly journals Frequency, Risk Factors, and Outcome of Coexistent Small Vessel Disease and Intracranial Arterial Stenosis

2016 ◽  
Vol 73 (1) ◽  
pp. 36 ◽  
Author(s):  
Hyung-Min Kwon ◽  
Michael J. Lynn ◽  
Tanya N. Turan ◽  
Colin P. Derdeyn ◽  
David Fiorella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Vessel Disease ◽  
Arterial Stenosis ◽  
Small Vessel ◽  
Intracranial Arterial Stenosis ◽  
Vessel Disease

scholarly journals Association between homocysteine and white matter hyperintensities in asymptomatic intracranial arterial stenosis: results from a population-based study

2019 ◽  
Author(s):  
Hao Yin ◽  
Xiang Wang ◽  
Yuan-yuan Zhao ◽  
Xiao-kang Ji ◽  
Shao-wei Sang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
White Matter ◽  
Magnetic Resonance ◽  
White Matter Hyperintensities ◽  
Population Based ◽  
Arterial Stenosis ◽  
Chinese People ◽  
Intracranial Arterial Stenosis ◽  
Population Based Study

Abstract Background: Although homocysteine (Hcy) and white matter hyperintensities (WMH) have been proven to be correlated with increased risks of ischemic stroke, there have been few studies addressing the association between serum Hcy and WMH in a population with asymptomatic intracranial arterial stenosis (aICAS). Thus, the aim of the present study is to describe the association between Hcy and WMH in rural-dwelling Chinese people with aICAS. Methods: In this study, 150 participants diagnosed as aICAS by magnetic resonance angiography were recruited from the Kongcun Town Study, which was a population-based study aimed to investigate the prevalence of aICAS in general population aged 40 to 90 years old, free of ischemic stroke history, and living in the Kongcun town, Pingyin county, Shandong, China. Data on demographics, risk factors, and serum Hcy levels were collected via interview, clinical examination, and laboratory tests. The WMH volumes were calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between Hcy and WMH volume was analyzed using both linear and logistic regression analysis. Results: After adjusting for all confounders, high Hcy (HHcy) (serum Hcy ≥15umol/L) was significantly associated with severe WMH (the highest quartile in WMH volume) (OR: 2.972, 95%CI: 1.017-7.979, P <0.05). However, with changing of WMH volumes, only trends towards association with HHcy were observed in all 3 models (P values only slightly exceeded 0.05). After being stratified by age, sex, or ever smoking, the association between HHcy and WMH became more significant in participants who were ≥60 years old, male, or ever smoker. Conclusions: HHcy is associated with severe WMH in rural-dwelling Chinese people with aICAS, especially in participants ≥60 years old, male participants, or ever smokers, indicating these may be risk factors that contribute to the association between HHcy and severe WMH.

Abstract 2634: A Prospective Study Of Asymptomatic Intracranial Arterial Stenosis In Japanese Healthy Subjects

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Ryukichi Matsui ◽  
Hiroaki Oguro ◽  
Nagai Atsushi ◽  
Hirokazu Bokura ◽  
Keiichi Onoda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Healthy Subjects ◽  
Significant Risk ◽  
Stroke Onset ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
A Prospective Study ◽  
Age And Sex

Background and purpose: Atherosclerotic stenosis of major intracranial arteries accounts for 5 to 10% of all causes of stroke. The Warfarin versus Aspirin Symptomatic Intracranial Disease (WASID) Study has demonstrated stroke onset in 5 among 100 patients with asymptomatic intracranial arterial stenosis (AIAS) during the follow-up period of 1.8 years. However, there are no prospective studies of intracranial stenosis in healthy subjects with a longer follow-up period. We conducted a 7-years longitudinal study in healthy subjects with AIAS to examine its risk factors and prognosis. Methods: We performed a prospective study on 3,155 neurologically normal subjects without history of stroke (1724 men, 1431 woman, mean age of 59). They were followed up with the mean interval of 83 months to obtain information about their stroke event with a questionnaire by mail or telephone interview and inquiry to the relevant medical facilities. AIAS were assessed on MRA at the time of first visit for all subjects. Result: AIAS was detected in 323 subjects (10.2%; AIAS group) at the initial examination. Significant risk factors for AIAS were older age, female, hypertension, high values of fasting blood glucose and HbA1c. During the follow-up stroke occurred in 77 subjects (2.7%) from the no-AIAS group and 14 subjects (4.3%) from the AIAS group (p = 0.07). Age and sex affected the stroke onset. The Cox's proportional-Hazards regression model after adjustment of age and sex revealed the significant contribution of AIAS on stroke onset (OR 1.9; 95% CI 1.03-3.4, p = 0.039). The stroke types were 11 ischemic and 3 hemorrhagic in the AIAS group. Conclusions: AIAS is a significant risk factor for future stroke even in healthy subjects. Intense management of blood pressure and glucose level might be crucial for preventing asymptomatic intracranial atherosclerotic disease.

Abstract WP2: Intracranial Stenting with the use of the Wingspan Intracranial Stent for Patients Presenting with Acute Stroke Symptoms and Critical Intracranial Arterial Stenosis.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Arash Padidar ◽  
Pejman Taghavi ◽  
Reza Malek ◽  
Ursula Tolley ◽  
Linda Catalli ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Ct Perfusion ◽  
Intravenous Thrombolysis ◽  
Intracranial Stenosis ◽  
Arterial Stenosis ◽  
Treatment Modalities ◽  
Intracranial Arterial Stenosis ◽  
Intracranial Stenting ◽  
Intracranial Stent ◽  
Increased Risk

Introduction: Patients with pre-existing severe intracranial arterial stenosis are at increased risk of re-current stroke. The treatment modalities for patients presenting with acute stroke symptoms are limited due to risk of re-occlusion after thrombolysis. Following re-canalization of an occluded stenotic vessel, stenting can prevent re-occlusion. Currently the only FDA approved stent specifically indicated for intracranial stenosis is the wingspan stent which is listed as a Humanitarian Use Device (HUD). With the efficacy and safety of intracranial stenting still in question we present a 3 year retrospective review of a community based hospitals outcomes with stenting in an acute stroke setting. Methods: Between 2009-2012 our group treated 47 patients with intracranial stenosis presenting with acute ischemic stroke. These patients had failure of intravenous thrombolysis or had contraindications for its use, had symptomatic intracranial stenosis or tandem lesions, had evidence of salvageable tissue determined by CT perfusion scanning and had an acute infarct not exceeding 1/3 of the affected vascular territory. All patients were treated within 12 hours of the acute event and received the Wingspan intracranial stent after successful thrombolysis. Fifteen patients had posterior circulation stenosis and 32 patients had anterior circulation stenosis. Results: The 30 day post-procedural stroke rate was 12.8%, with a total early mortality rate of 8.4% (Table). The 35 patients with no complications had an average of 4 points improvement in NIHSS post procedure (Figure). Of these patients 15 were discharged home, 10 discharged to acute rehabilitation facilities, and 10 were transferred to nursing homes. Conclusion: Intracranial stenting using the Wingspan device results in significant clinical improvement in patients with acutely symptomatic intracranial stenosis, with acceptable mortality and low rate of symptomatic intracranial hemorrhage.

scholarly journals Intracranial arterial stenosis in Caucasian versus Chinese patients with TIA and minor stroke: two contemporaneous cohorts and a systematic review

2021 ◽  
pp. jnnp-2020-325630
Author(s):  
Xinyi Leng ◽  
Robert Hurford ◽  
Xueyan Feng ◽  
Ka Lung Chan ◽  
Frank J Wolters ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Vascular Risk Factor ◽  
Vascular Risk Factors ◽  
Arterial Stenosis ◽  
Chinese Patients ◽  
Minor Stroke ◽  
Vascular Risk ◽  
Intracranial Arterial Stenosis ◽  
Different Populations

BackgroundIntracranial arterial stenosis (ICAS) is an important cause of stroke worldwide. Separate reports in Caucasians and Asians with stroke/transient ischaemic attack (TIA) have suggested lower ICAS prevalence in Caucasians, but there has been no direct comparisons of the two ethnic groups with the same criteria to define ICAS.MethodsAcute minor stroke or TIA patients in two cohorts respectively recruiting patients in Oxford (2011–2018, predominantly Caucasians) and Hong Kong (2011–2015, predominantly Chinese) were compared. ICAS was defined as ≥50% stenosis/occlusion in any major intracranial artery in MR/CT angiography. Prevalence, distribution and risk factors of ICAS were compared between the two cohorts. We also systematically reviewed literature on ICAS prevalence in stroke/TIA patients in different populations.ResultsAmong 1287 patients from Oxford and 691 from Hong Kong (mean age 69 vs 66), ICAS prevalence was higher in Chinese than in Caucasians (43.0% vs 20.0%; OR 3.02; 95% CI 2.47 to 3.70; p<0.001), independent of age (age-adjusted OR 3.73; 95% CI 3.00 to 4.63; p<0.001) and vascular risk factors (multivariable-adjusted OR 3.21; 95% CI 2.56 to 4.02; p<0.001). This ethnic difference was greater (p interaction=0.005) at age <70 years (OR 5.33; 95% CI 3.79 to 7.50; p<0.001) than at ≥70 years (OR 2.81; 95% CI 2.11 to 3.74; p<0.001). ICAS prevalence increased with age and with vascular risk factors in both cohorts, with equivalent prevalence in Chinese aged <60 years and Caucasians aged ≥80, and in Chinese with no vascular risk factor and Caucasians with two vascular risk factors. ICAS locations also differed between Chinese and Caucasian patients.ConclusionsChinese are more susceptible to ICAS than Caucasians, with an earlier onset age and a higher prevalence, independent of vascular risk factors.

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