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Intracranial artery calcification: Frequency, determinants, and modification of outcomes from endovascular thrombectomy.
Phan, Allan Q; Yoo, Bryan; Liebeskind, David S; Sharma, Latisha K; Bahr-Hosseini, Mersedeh; Alfonso, Rodel; Jahan, Reza; Duckwiler, Gary R; Tateshima, Satoshi; Nour, May; Szeder, Victor; Colby, Geoffrey P; Gornbein, Jeffrey; Saver, Jeffrey L.
Afiliación
  • Phan AQ; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA; Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, USA. Electronic address: aqlphan@gmail.com.
  • Yoo B; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Liebeskind DS; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Sharma LK; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Bahr-Hosseini M; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Alfonso R; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Jahan R; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Duckwiler GR; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Tateshima S; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Nour M; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Szeder V; Department of Radiology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Colby GP; Department of Neurosurgery and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
  • Gornbein J; Departments of Medicine and Computational Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
  • Saver JL; Department of Neurology and Comprehensive Stroke Center, UCLA, Los Angeles, CA, USA.
J Stroke Cerebrovasc Dis ; 33(11): 107898, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39106922
ABSTRACT

INTRODUCTION:

Intracranial artery calcification (ICAC) is a common finding on computed tomography (CT) in patients presenting with large vessel occlusion acute ischemic stroke (LVO-AIS) and could serve as a useful biomarker of intracranial atherosclerosis and altered intracranial vessel pliability in patients undergoing endovascular thrombectomy (EVT).

METHODS:

This was a retrospective cohort study analyzing consecutive patients undergoing CT head prior to EVT between 2016 and 2020. Extent of ICAC proximal to the target vessel was scored using a validated grading scale examining thickness and circumferential extent of calcifications. The relationship between 3 levels of ICAC burden and procedural, clinical, and safety outcomes was analyzed.

RESULTS:

Among 86 patients meeting inclusion criteria, ICAC of any degree was present in 72.1 %. Median ICAC score was 3 [IQR 0-4]. There was a U-shaped association between ICAC score and successful reperfusion 90.9 %, 65.7 %, and 94.4 % in the low, intermediate, and high ICAC score groups, respectively (p = 0.008). Use of rescue intervention, most often angioplasty and stenting, was greatest in the high ICAC score group 3.0 % vs. 5.7 % vs. 22.2 % (p = 0.05). Functional independence at 90 days did not differ significantly among groups (41.7 % vs. 31.0 % vs. 15.4 %, p = 0.26), nor did rates of symptomatic intracranial hemorrhage (15.2 % vs. 14.3 % vs. 16.7 %, p = 0.97).

CONCLUSIONS:

ICAC is seen on CT in nearly three-quarters of patients with LVO-AIS. Extent of ICAC has a U-shaped association with successful reperfusion, in part due to more frequent use of rescue interventions in patients with extensive ICAC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombectomía / Procedimientos Endovasculares / Calcificación Vascular / Accidente Cerebrovascular Isquémico Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombectomía / Procedimientos Endovasculares / Calcificación Vascular / Accidente Cerebrovascular Isquémico Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos