Association of Perforator Stroke After Basilar Artery Stenting With Negative Remodeling

Ma, Ning; Xu, Ziqi; Lyu, Jinhao; Li, Mingyao; Hou, Zhe; Liu, Yifan; Yang, Ming; Mo, Dapeng; Gao, Feng; Song, Ligang; Sun, Xuan; Liu, Xin; Sui, Binbin; Shen, Mowei; Ma, Lin; Wang, Yilong; Wang, Yongjun; Miao, Zhongrong; Lou, Xin

doi:10.1161/strokeaha.118.023838

Cited by 19 publications

(19 citation statements)

References 12 publications

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“…Our study found one patient with overperfusion and one patient with hemorrhage in the early stenting group; no patient had overperfusion of intracranial hemorrhage in the later stenting group. Third, from our data we found that more lesions in the early group were in the intracranial vertebral and basilar artery, which has a higher risk of leading to perforator stroke than anterior circulation 19. With regard to our findings, we speculate that intracranial stenting on recently symptomatic, still vulnerable plaques are more likely to cause plaque dislodgement, perforator stroke, and intracranial hemorrhage.…”

Section: Discussionsupporting

confidence: 49%

Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke

Zhang

Sun

et al. 2019

J NeuroIntervent Surg

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ObjectiveTo evaluate the clinical outcomes of early stenting (≤14 days) or late stenting (>14 days) in patients who underwent intracranial stent placement.MethodsPatients with ischemic stroke caused by 70–99% intracranial atherosclerotic stenosis combined with poor collaterals were enrolled. The early stenting group, who underwent stenting within 14 days of last ischemic symptoms, were compared with the late stenting group who underwent stenting >14 days from last ischemic symptom. The patients were treated either with a balloon-mounted stent or a self-expanding stent as determined by the operators following a guideline. The baseline characteristics and clinical outcomes were evaluated and compared.ResultsOne hundred and fifteen stroke patients were recruited into the study. Four patients (4/41) in the early stenting group and two patients (2/74) in the late stenting group were diagnosed with a cerebral vascular event associated with stenting within 3 days (p=0.184). In the long-term follow-up, eight patients in the early stenting group had restenosis ≥50%, which was higher than patients in the late stenting group (8/41 vs 4/74, p=0.018). The total rates of any ischemic stroke, transient ischemic attack, hemorrhagic stroke, and death in the early stenting group were higher than in the late stenting group (9/41 vs 6/74, p=0.035). The recurrence rate of ischemic stroke in the early stenting group was higher than in the late stenting group (5/41 vs 2/74, p=0.041).ConclusionsStent placement in the setting of ischemic stroke caused by intracranial artery stenosis within 14 days may confer a higher risk of long-time cerebral vascular events and lead to a higher risk of restenosis.Clinical trial registrationNCT01968122.

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Section: Discussionsupporting

confidence: 49%

Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke

Zhang

Sun

et al. 2019

J NeuroIntervent Surg

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“…Strong enhancement was equal to or stronger than that of the pituitary infundibulum (eFigure 4 in the online-only Data Supplement). 19 In this study, positive remodelling, diffuse distribution, intraplaque haemorrhage and strong enhancement were recognized as ICAP-vulnerable features as previous studies have showed their close relationships with future ischemic events. [14][15][16][17] Image reconstruction was performed at the workstation.…”

Section: Imaging Analysis and Measurementsmentioning

confidence: 71%

“…Strong enhancement was equal to or stronger than that of the pituitary infundibulum (eFigure 4 in the online-only Data Supplement). 19…”

Section: Methodsmentioning

confidence: 99%

Different risk factors in identical features of intracranial atherosclerosis plaques in the posterior and anterior circulation in high-resolution MRI

Lyu

et al. 2020

Ther Adv Neurol Disord

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Background: We constructed a high-volume registry to identify whether risk factors of intracranial atherosclerotic plaque (ICAP) features differ in the posterior and anterior circulation in patients with symptomatic intracranial atherosclerotic stenosis (ICAS) investigated by high-resolution magnetic resonance imaging (HRMRI). Methods: The registry was constructed for patients with symptomatic ICAS who underwent HRMRI for culprit plaques. ICAP-vulnerable features included positive remodelling, diffuse distribution, intraplaque haemorrhage and strong enhancement. Results: We analysed risk factors for the same ICAP features between the posterior and anterior circulation in data of 97 patients in the posterior circulation and 105 patients in the anterior circulation ICAPs. In patients with diffuse distribution, the probability of being female were lower [odds ratio (OR):0.08; 95% confidence interval (CI):0.02–0.34; p = 0.001] and having diabetes mellitus was higher (OR: 7.75; 95% CI:1.75–34.39; p = 0.007) in posterior circulation patients. In patients with strong enhancement, the probability of having diabetes was higher in posterior circulation patients (OR:6.71; 95% CI:1.37–32.81; p = 0.019). Conclusions: Our results demonstrate more risk factors in the posterior than in the anterior circulation in patients with the same ICAP-vulnerable features, highlighting the need for stratification of risk factors in symptomatic ICAPs. Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02705599.

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“…We adopted the same principle when interpreting HRMRI imaging for arterial remodeling and vessel wall features as we published before with small intra-observer and inter-observer variability [10, 17, 21]. The intra- and inter-observer variability of the two HRMRI scanners and identified vessel wall features were good to excellent (weighted k = 0.82, 95% CI: 0.46, 1.00 and 0.83, 95% CI: 0.41–1.00, respectively).…”

Section: Methodsmentioning

confidence: 99%

Association between basilar artery configuration and Vessel Wall features: a prospective high-resolution magnetic resonance imaging study

Hou

et al. 2019

BMC Med Imaging

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BackgroundThe relationship between intracranial vessel configuration and wall features remains poorly investigated. Therefore, we aimed to investigate the relationship between the distal and proximal anatomical configuration of basilar artery (BA) and BA vessel wall features on high-resolution magnetic resonance imaging (HRMRI).MethodsFrom September 2014 to January 2017, patients with suspected symptomatic intracranial arterial stenosis underwent HRMRI. Patients with severe BA stenosis were selected for this prospective study and divided into two groups corresponding to complete and incomplete BA configuration based on characteristics of the bilateral vertebral arteries and posterior cerebral arteries. Culprit blood vessel wall features on HRMRI included plaque enhancement, intraplaque hemorrhage, remodeling patterns, and plaque distribution. Culprit vessel wall features were compared between patients in the complete and incomplete BA configuration groups.ResultsAmong the 298 consecutively enrolled patients, 34 had severe BA stenosis. Twenty patients had complete anatomical BA configuration and another 14 of them displayed incomplete configuration. There were no significant differences in vessel wall features between the complete and incomplete configuration patient groups. However, the proximal configuration of BA was associated with intraplaque hemorrhage (p = 0.002) while the distal configuration of BA correlated with strong enhancement of BA plaque (p = 0.041).ConclusionsNo association was found between the complete and incomplete BA configuration groups and blood vessel wall features. The proximal configuration of BA was related with intraplaque hemorrhage and the distal configuration of BA was associated with strong plaque enhancement. Further studies are warranted to confirm these findings.Trial registrationURL: Unique identifier: NCT02705599 (March 10, 2016).

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Association of Perforator Stroke After Basilar Artery Stenting With Negative Remodeling

Cited by 19 publications

References 12 publications

Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke

Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke

Different risk factors in identical features of intracranial atherosclerosis plaques in the posterior and anterior circulation in high-resolution MRI

Association between basilar artery configuration and Vessel Wall features: a prospective high-resolution magnetic resonance imaging study

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