Independent predictors of ischemic stroke: a comprehensive scan of the internal carotid and vertebrobasilar systems.

BACKGROUND

Stroke has the highest individual disability rate of all ischemic cardiovascular diseases. Thus, the early identification of its risk factors are crucial to reduce its incidence and improve unfavorable prognoses. This study investigated the value of the most reliable predictors of ischemic stroke by comprehensively scanning the internal carotid artery system and vertebrobasilar artery system using integrated cervicocerebral ultrasound (ICCUS).

METHODS

Patients who had undergone ICCUS scanning and who had recently had a non-cardiac ischemic stroke (<30 days) were prospectively included in this study. Relevant ICCUS parameters were recorded for the carotid, vertebral, subclavian, and intracranial arteries, and intracranial collaterals. The independent predictors of ischemic stroke were examined by multivariate logistic regression analysis. The receiver operating characteristic curves and area under the curve (AUC) were used to evaluate the predictive effects.

RESULTS

From July 2023 to April 2024, 127 patients were included in the final analysis, of whom, 42 had suffered a stroke and 85 had not suffered a stroke. The multivariate logistic regression analysis showed that the presence of intraplaque hemorrhage (IPH), multiple stenoses in the anterior and posterior cerebral arteries, and opening of the anterior communicating artery within the cerebral collateral on ICCUS scanning were independent predictors of ischemic stroke (all P<0.05). The corresponding odds ratios for these factors were 5.20, 21.63, 19.87, and 4.58, respectively, and the AUC was 0.802 (95% confidence interval: 0.71-0.89, P<0.001). In addition, if the IPH predictor for cervical vessels was combined with any of the one to three predictors for the intracranial vessels, the combined the diagnostic accuracies progressively increased to 68.1-71.4%, 74.5-76.0%, and 80.2%, respectively.

CONCLUSIONS

This study used ICCUS, a comprehensive, accurate, and efficient ultrasound technology, to identify more reliable independent predictors of ischemic stroke. Our findings may guide the early prevention and timely treatment of patients.