Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2015
Endovascular Therapy of Cerebral Arterial Occlusions: Intracranial Atherosclerosis versus Embolism.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lee Jin Soo, Hong Ji Man, Lee Kyu Sun, Suh Hong Il, Demchuk Andrew M, Hwang Yang-Ha, Kim Byung Moon, Kim Jong S
Аннотация
BACKGROUND: Treatment strategy for acute arterial occlusions due to intracranial atherosclerotic disease (IAD) may differ from those due to embolism (embolic). The aims were to differentiate and classify angiographically defined occlusion due to IAD versus embolism and identify baseline clinical factors associated with IAD-related occlusion.
METHODS: Acute ischemic stroke patients with large cerebral artery occlusions on computed tomography angiography who underwent transfemoral cerebral angiography for endovascular treatment were included. Patients were categorized as the embolic (no evidence of focal stenosis after recanalization) or IAD group (significant fixed focal stenosis in the occlusion site, evidenced in the final angiography or during the endovascular treatment procedure) based on transfemoral cerebral angiography findings.
RESULTS: In total, 158 patients were included. The IAD group patients (n = 24) were younger (P = .005), more often male (P < .001) and smokers (P < .001), and had a higher total cholesterol level (P = .001) than patients in the embolic group (n = 134). The posterior circulation was more frequently involved in the IAD group (P = .001). Independent predictors of IAD on multivariable analysis were male sex (odds ratio, 6.42 [95% confidence interval, 1.25-32.97], P = .026), posterior circulation involvement (3.57 [1.09-11.75], P = .036), and high total cholesterol levels (1.02 [1.01-1.03], P = .008).
CONCLUSIONS: Male sex, hypercholesterolemia, and posterior circulation involvement are associated with higher likelihood of underlying IAD as the etiology for the intracranial arterial occlusion. In patients with these characteristics, underlying IAD may have to be considered and the endovascular treatment strategy may have to be modified.
METHODS: Acute ischemic stroke patients with large cerebral artery occlusions on computed tomography angiography who underwent transfemoral cerebral angiography for endovascular treatment were included. Patients were categorized as the embolic (no evidence of focal stenosis after recanalization) or IAD group (significant fixed focal stenosis in the occlusion site, evidenced in the final angiography or during the endovascular treatment procedure) based on transfemoral cerebral angiography findings.
RESULTS: In total, 158 patients were included. The IAD group patients (n = 24) were younger (P = .005), more often male (P < .001) and smokers (P < .001), and had a higher total cholesterol level (P = .001) than patients in the embolic group (n = 134). The posterior circulation was more frequently involved in the IAD group (P = .001). Independent predictors of IAD on multivariable analysis were male sex (odds ratio, 6.42 [95% confidence interval, 1.25-32.97], P = .026), posterior circulation involvement (3.57 [1.09-11.75], P = .036), and high total cholesterol levels (1.02 [1.01-1.03], P = .008).
CONCLUSIONS: Male sex, hypercholesterolemia, and posterior circulation involvement are associated with higher likelihood of underlying IAD as the etiology for the intracranial arterial occlusion. In patients with these characteristics, underlying IAD may have to be considered and the endovascular treatment strategy may have to be modified.