Coronary and Basilar Artery Ectasia Are Associated

Pico, Fernando; Labreuche, Julien; Hauw, Jean‐Jacques; Seilhean, Danielle; Duyckaerts, Charles; Amarenco, Pierre

doi:10.1161/strokeaha.115.010797

Cited by 22 publications

(9 citation statements)

References 15 publications

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“…Interestingly, a previous study suggested that IADE patients were eligible to have a previous myocardial infarction [18], and the coronary artery ectasia was also correlated with ischemic heart disease [19]. Concomitant coronary and basilar artery ectasia in stroke patients may suggest common pathogenesis [20]. However, in multivariable analysis, we did not find the statistical difference of vascular risk factors such as age, hypertension, diabetes mellitus, hyperlipidemia, smoking between the recurrence and none-recurrence group.…”

Section: Discussioncontrasting

confidence: 66%

“…This study found that VBD patients had a frequent incidence of ICAS, and this proportion was higher in recurrent cases; however, we did not find its association with IS recurrence in multivariate analysis. IADE may differ with ICAS; autopsy study found that IADE is associated with rarefaction of elastic tissue of the tunica media with the degeneration of the internal elastic laminin [20,22], while atherosclerosis always has a pathological change of plaque with a lipid core and the fibrous cap [23]. Also, hemodynamic abnormalities such as the wall shear stress, noticeable eddy currents in dolichoectasia vertebrobasilar artery were reported, and notably, without apparent arterial stenosis [24].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Risk of Ischemic Stroke due to Vertebrobasilar Dolichoectasia

Chen

Zhang

Dai

et al. 2019

Preprint

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Background Patients with vertebrobasilar dolichoectasia usually have persistent hemodynamic abnormalities, and therefore, may bear an increased risk of stroke. This study aimed to evaluate ischemic stroke recurrence in patients with vertebrobasilar dolichoectasia. Methods Patients with acute ischemic stroke were screened and evaluated for eligibility. Enrolled patients were followed via scheduled clinical visits or telephone interviews. Ischemic stroke recurrence was proposed with clinical symptoms and confirmed with cranial Magnetic Resonance Imaging or Computerized Tomography scans. Baseline characteristics and vascular geometry were compared between patients with and without stroke recurrence. Significant parameters were introduced into COX proportional hazard model to detect possible predictors of stroke recurrence. Results A total of 115 stroke patients with vertebrobasilar dolichoectasia were enrolled, of which 22 (19.1%) had recurrence during 22 ± 6 months follow-up. Basilar artery diameter ≥ 5.3 mm (HR = 4.744; 95% CI, 1.718-13.097; P = 0.003), diffuse intracranial dolichoectasia (HR = 3.603; 95% CI, 1.367-9.496; P = 0.010) and ischemic heart disease history (HR = 4.095; 95% CI, 1.221-13.740; P = 0.022) had increased risk of recurrence. Conclusions Stroke patients with vertebrobasilar dolichoectasia may have a high risk of recurrence. Larger basilar artery diameter or diffuse intracranial dolichoectasia may increase the risk of recurrence.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Recurrent Risk of Ischemic Stroke due to Vertebrobasilar Dolichoectasia

Chen

Zhang

Dai

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Interestingly, previous study found that IADE patients were eligible to have a previous myocardial infarction [18], and the coronary artery ectasia was also correlated with ischemic heart disease [19]. Concomitant coronary and basilar artery ectasia in stroke patients may suggest common pathogenesis [20]. However, in multivariable analysis, we did not find the statistical difference of vascular risk factors such as age, hypertension, diabetes mellitus, hyperlipidemia, smoking between the recurrence and non-recurrence groups.…”

Section: Discussionmentioning

confidence: 99%

Recurrent risk of ischemic stroke due to Vertebrobasilar Dolichoectasia

et al. 2019

View full text Add to dashboard Cite

Background Patients with vertebrobasilar dolichoectasia usually have persistent hemodynamic abnormalities, and therefore, may bear an increased risk of stroke. This study aimed to identify risk factors for stroke recurrence in patients with vertebrobasilar dolichoectasia. Methods Patients with acute ischemic stroke were screened and evaluated for eligibility. Enrolled patients were followed via scheduled clinical visits or telephone interviews. Ischemic stroke recurrence was proposed with clinical symptoms and confirmed with cranial Magnetic Resonance Imaging or Computerized Tomography scans. Baseline characteristics and vascular geometry were compared between patients with and without stroke recurrence. Significant parameters were introduced into COX proportional hazard model to detect possible predictors of stroke recurrence. Results A total of 115 stroke patients with vertebrobasilar dolichoectasia were enrolled, of which 22 (19.1%) had recurrence during 22 ± 6 months follow-up. Basilar artery diameter ≥ 5.3 mm (HR = 4.744; 95% CI, 1.718–13.097; P = 0.003), diffuse intracranial dolichoectasia (HR = 3.603; 95% CI, 1.367–9.496; P = 0.010) and ischemic heart disease history (HR = 4.095; 95% CI, 1.221–13.740; P = 0.022) had increased risk of recurrence. Conclusions Stroke patients with vertebrobasilar dolichoectasia may have a high risk of recurrence. Larger basilar artery diameter or diffuse intracranial dolichoectasia may increase the risk of recurrence.

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“…Genetic alterations may lead to a predisposition to defects in arterial wall ECM components such as collagen, elastin, proteoglycans, and laminin, thus making these vessels susceptible to dilatation. The co-occurrence of IADE with abdominal aortic aneurysm and coronary artery ectasias has been reported, indicating that there may be a generalized (genetic) rather than a local (atherosclerosis) cause for the abnormal arterial dilatation [ 69 ]. In Caucasians, VBD is independently associated with LI, suggesting that racial factors may be involved in the association between VBD and CSVD [ 70 ].…”

Section: Mechanisms Underlying the Association Between Iade And Csvdmentioning

confidence: 99%

Association between Intracranial Arterial Dolichoectasia and Cerebral Small Vessel Disease and Its Underlying Mechanisms

et al. 2020

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Intracranial arterial dolichoectasia (IADE), also known as dilatative arteriopathy of the brain vessels, refers to an increase in the length and diameter of at least one intracranial artery, and accounts for approximately 12% of all patients with stroke. However, the association of IADE with stroke is usually unclear. Cerebral small vessel disease (CSVD) is characterized by pathological changes in the small vessels. Clinically, patients with CSVD can be asymptomatic or present with stroke or cognitive decline. In the past 20 years, a series of studies have strongly promoted an understanding of the association between IADE and CSVD from clinical and pathological perspectives. It has been proposed that IADE and CSVD may be attributed to abnormal vascular remodeling driven by an abnormal matrix metalloproteinase/tissue inhibitor of metalloproteinase pathway. Also, IADErelated hemodynamic changes may result in initiation or progression of CSVD. Additionally, genetic factors are implicated in the pathogenesis of IADE and CSVD. Patients with Fabry’s disease and late-onset Pompe’s disease are prone to developing concomitant IADE and CSVD, and patients with collagen IV alpha 1 or 2 gene (<i>COL4A1/COL4A2</i>) and forkhead box C1 (<i>FOXC1</i>) variants present with IADE and CSVD. Race, strain, familial status, and vascular risk factors may be involved in the pathogenesis of IADE and CSVD. As well, experiments in mice have pointed to genetic strain as a predisposing factor for IADE and CSVD. However, there have been few direct genetic studies aimed towards determining the association between IADE and CSVD. In the future, more clinical and basic research studies are needed to elucidate the causal relationship between IADE and CSVD and the related molecular and genetic mechanisms.

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Coronary and Basilar Artery Ectasia Are Associated

Cited by 22 publications

References 15 publications

Recurrent Risk of Ischemic Stroke due to Vertebrobasilar Dolichoectasia

Recurrent Risk of Ischemic Stroke due to Vertebrobasilar Dolichoectasia

Recurrent risk of ischemic stroke due to Vertebrobasilar Dolichoectasia

Association between Intracranial Arterial Dolichoectasia and Cerebral Small Vessel Disease and Its Underlying Mechanisms

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