scholarly journals Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI

2018 ◽  
Vol 39 (7) ◽  
pp. 1286-1292 ◽  
Author(s):  
C. Zhu ◽  
X. Tian ◽  
A.J. Degnan ◽  
Z. Shi ◽  
X. Zhang ◽  
...  
Keyword(s):  
High Resolution ◽  
Clinical Significance ◽  
Basilar Artery ◽  
Artery Stenosis ◽  
Intraplaque Hemorrhage ◽  
High Grade ◽  
High Resolution Mri ◽  
Basilar Artery Stenosis

Abstract W MP17: Basilar Plaque on High Resolution Mri Predicts Early Neurologic Deterioration After Pontine Infarction

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Hyun Young Kim ◽  
Young Seo Kim ◽  
Kyu-Yong Lee ◽  
Seong-Ho Koh ◽  
Sung Hyuk Heo ◽  
...  
Keyword(s):  
High Resolution ◽  
Basilar Artery ◽  
Univariate Analysis ◽  
Artery Stenosis ◽  
Accurate Information ◽  
Neurologic Deterioration ◽  
High Resolution Mri ◽  
Pontine Infarction ◽  
Intracranial Artery Stenosis ◽  
Typical Lesion

Background: The association between early neurologic deterioration (END) in pontine infarction and basilar stenosis remains unclear. Recently, it has been reported that evaluation of the basilar artery using high-resolution MRI (HRMRI) could provide more accurate information about intracranial artery stenosis than MR angiography (MRA). We aimed this study to identify the relationship between basilar plaque assessed by HRMRI and END after pontine infarction. Methods: Ninety consecutive patients with unilateral pontine infarction within 24 hours of stroke onset were included. All patients underwent diffusion weighted MRI, MRA and HRMRI within 24 hours after admission. Basilar stenosis was assessed with MRA and HRMRI. Basilar plaque on HRMRI was classified as 1) "no plaque" when the wall of the basilar artery was clear; 2) "minimal plaque" when the basilar wall was irregular without clear crescentic thickening; and 3) "apparent plaque" when a typical lesion with a crescentic thickening of the wall could be seen. END was defined as increased NIHSS score by ≥2 during admission. Factors potentially associated with END were validated by multivariate analyses. Results: Sixty-six patients (73%) had paramedian pontine infarction (PPI) and 24 patients (27%) had deep pontine infarction (DPI). END was observed in 29 (32%) patients and they all had PPI. Patients with END had more frequent apparent plaque in basilar artery than without it (79% versus 33%, p=0.001). However, basilar stenosis (>30%) assessed by MRA did not show any differences regardless of the presence of END (24% versus 17%, p=0.380). In univariate analysis with the patients with PPI, END was associated with hypertension (p=0.029) and apparent plaque (p=0.002). After adjusting covariates, END was independently associated with hypertension (OR, 6.672; 95% CI, 1.376-32.367) and apparent plaque (OR, 7.260; 95% CI 1.285-41.030). Conclusion: Our result suggest that basilar stenosis assessed by HRMRI was associated with END in patients with acute pontine infarction. However, the result was not significant when assessed by MRA. We suggest that since basilar stenosis are underestimated with MRA, HRMRI may be more useful in evaluating basilar artery stenosis and predicting END in pontine infarction.

High Risk of Recurrent Ischemic Events Among Patients With Deferred Intracranial Angioplasty and Stent Placement for Symptomatic Intracranial Atherosclerosis

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. 334-343 ◽  
Author(s):  
Osman Kozak ◽  
Nauman Tariq ◽  
M. Fareed K. Suri ◽  
Robert A. Taylor ◽  
Adnan I. Qureshi
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Stent Placement ◽  
Recurrent Events ◽  
Artery Stenosis ◽  
Intracranial Stenosis ◽  
High Grade ◽  
Best Medical Treatment ◽  
Basilar Artery Stenosis ◽  
Ischemic Events

Abstract BACKGROUND: Intracranial angioplasty with or without stent placement has been performed to treat patients with recurrent cerebral ischemic events despite best medical therapy or those with high-grade stenosis. OBJECTIVE: To evaluate early recurrent stroke/transient ischemic attack rates in a cohort of patients with symptomatic >50% intracranial stenosis in whom intracranial angioplasty and stent placement was initially deferred. METHODS: All patients presenting to 2 academic hospitals with symptomatic intracranial disease between 2006 and 2008 who underwent catheter angiography were identified. Patients with complete intracranial occlusion or stenosis less than 50% stenosis were excluded (n = 14). RESULTS: Thirty-one patients met the study criteria. Sixteen (52%) patients were on antiplatelet medications at the time of the initial event, and 2 patients were also on anticoagulant medications. Six patients (19%) underwent intracranial angioplasty and/or stent placement with their initial diagnostic angiogram. Twenty-five patients (81%) had endovascular treatment deferred for best medical treatment in the interim period. Among the 25 patients who were kept on medical management, 14 (56%) were readmitted with recurrent ischemic events in the distribution of the target artery within a median of 28 days (range, 1-243 days). Recurrent events occurred within 1 week in 8 (57%) patients, between 7 days and 1 month in 4 (29%) patients, 1 to 3 months in 1 (7%) patient, and after 3 months in 1 (7%) patient. Recurrent ischemic events were observed in all 5 patients with basilar artery stenosis and in 13 of 17 patients with severity of stenosis ≥70%. CONCLUSION: A high rate of recurrent ischemic events was observed among patients in whom endovascular treatment was deferred, particularly those with basilar artery stenosis and those with high-grade stenosis. This information would be beneficial in decision making for timing of the endovascular treatment among patients with symptomatic intracranial stenosis.

scholarly journals Incremental Value of Plaque Enhancement in Patients with Moderate or Severe Basilar Artery Stenosis: 3.0 T High-Resolution Magnetic Resonance Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wanqian Wang ◽  
Qi Yang ◽  
Debiao Li ◽  
Zhaoyang Fan ◽  
Xiaoming Bi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Basilar Artery ◽  
Morphological Characteristics ◽  
Multivariate Regression Analysis ◽  
Intraplaque Hemorrhage ◽  
Asymptomatic Group ◽  
Asymptomatic Patients ◽  
Basilar Artery Stenosis ◽  
3.0 T

Aim. To investigate the clinical relevance of plaque’s morphological characteristics and distribution pattern using 3.0 T high-resolution magnetic resonance imaging (HRMRI) in patients with moderate or severe basilar artery (BA) atherosclerosis stenosis. Materials and Methods. Fifty-seven patients (33 symptomatic patients and 24 asymptomatic patients) were recruited for 3.0 T HRMRI scan; all of them had >50% stenosis on the BA. The intraplaque hemorrhage (IPH), contrast-enhancement pattern, and distribution of BA plaques were compared between the symptomatic and asymptomatic groups. Factors potentially associated with posterior ischemic stroke were calculated by multivariate analyses. Results. Enhancement of BA plaque was more frequently observed in symptomatic than in asymptomatic patients (27/33, 81.8% versus 11/24, 45.8%; p<0.01). In multivariate regression analysis, plaque enhancement (OR = 7.193; 95% CI: 1.880–27.517; p=0.004) and smoking (OR = 4.402; 95% CI: 2.218–15.909; p=0.024) were found to be independent risk factors of posterior ischemic events in patients with BA stenosis >50%. Plaques were mainly distributed at the ventral site (39.3%) or involved more than two arcs (21.2%) in the symptomatic group but were mainly distributed at left (33.3%) and right (25.0%) sites in the asymptomatic group.

Endovascular Drug-Coated Stenting of Basilar Artery Stenosis: A Case Report and Literature Review

2004 ◽  
Vol 34 (9) ◽  
pp. 913 ◽  
Author(s):  
Chang Mo Moon ◽  
Sung Ha Chun ◽  
Jin Bae Kim ◽  
Jae Hun Jung ◽  
Young Guk Ko ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Basilar Artery ◽  
Artery Stenosis ◽  
Basilar Artery Stenosis
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