Association of Carotid Artery Endothelial Signal Intensity Gradient with Unilateral Large Artery Ischemic Stroke

Abstract

<b><i>Background:</i></b> Common carotid artery (CCA) and internal carotid artery (ICA) are aligned linearly, but their hemodynamic role in ischemic stroke has not been studied in depth. <b><i>Objectives:</i></b> We aimed to investigate whether CCA and ICA endothelial shear stress (ESS) could be associated with the ischemic stroke of large artery atherosclerosis (LAA). <b><i>Methods:</i></b> We enrolled consecutive patients with unilateral ischemic stroke of LAA and healthy controls aged >60 years in the stroke center of Jeonbuk National University Hospital. All patients and controls were examined with carotid artery time-of-flight magnetic resonance angiography, and their endothelial signal intensity gradients (SIGs) were determined, as a measure of ESS. The effect of right or left unilateral stroke on the association between carotid artery endothelial SIG and ischemic stroke of LAA was assessed. <b><i>Results:</i></b> In total, the results from 132 patients with ischemic stroke of LAA and 121 controls were analyzed. ICA endothelial SIG showed significant and independent associations with the same-sided unilateral ischemic stroke of LAA, even after adjusting for the potential confounders including carotid stenosis, whereas CCA endothelial SIG showed a significant association with the presence of the ischemic stroke of LAA. <b><i>Conclusion:</i></b> Although CCA and ICA are located with continuity, the hemodynamics and their roles in large artery ischemic stroke should be considered separately. Further studies are needed to delineate the pathophysiologic roles of ESS in CCA and ICA for large artery ischemic stroke.

Cerebral artery signal intensity gradient from Time-of-Flight Magnetic Resonance Angiography and clinical outcome in lenticulostriate infarction: a retrospective cohort study

“…Arterial wall SIG was measured for all cerebral arteries concurrently using TOF-MRA in the acute stage of infarction. Arterial wall SIG has been shown to reveal hemodynamic features in various vascular diseases, including moyamoya disease ( 12 ) and ischemic stroke of large artery atherosclerosis ( 13 ). We conducted a retrospective analysis of patients with lenticulostriate infarction from three nationwide stroke centers, collecting clinical data, including modified Rankin Scale (mRS) at discharge.…”

Geometric versus hemodynamic indexes for rupture-destined aneurysms: a retrospective cohort and a repeated-measures study

“…20 The in vivo nature of SIG has been shown to be useful in identifying the relationship between WSS and the progression of moyamoya disease, 21 and in determining the laterality of ischemic stroke related to large artery atherosclerosis. 22…”

“…20 The in vivo nature of SIG has been shown to be useful in identifying the relationship between WSS and the progression of moyamoya disease, 21 and in determining the laterality of ischemic stroke related to large artery atherosclerosis. 22 In the present study, we aimed to evaluate the utility of geometric or hemodynamic indexes in differentiating RDA and UIA, and to understand the characteristics of natural evolutionary changes of UIA. For this purpose, we performed (1) a retrospective cohort study among patients with IA for comparing RDA and UIA, and (2) a longitudinal re-examination of UIA.…”

Geometric versus Hemodynamic Indexes for Rupture-Destined Aneurysms: A Retrospective Cohort and a Repeated-Measures Study

“…Arterial wall signal intensity gradient (SIG) is a noninvasive way to measure WSS [15]. The in vivo nature of SIG has been shown to be valuable in identifying the relationship between WSS and moyamoya disease progression [16] and laterality of ischemic stroke related to large artery atherosclerosis [17].…”