Misery Perfusion, Blood Pressure Control, and 5-Year Stroke Risk in Symptomatic Major Cerebral Artery Disease

Abstract

O-gas positron emission tomography, and patients received medical treatment and they were followed for 5 years or until stroke recurrence or death. Results-During 5 years, strokes occurred in 6 of 16 patients with MP and in 15 of 114 without MP (log-rank test; P<0.01).There were 4 (25%) ipsilateral ischemic strokes in patients with MP and 4 in those without MP (P<0.001). The risk of ipsilateral ischemic stroke declined markedly after 2 years, and there was only 1 ipsilateral ischemic stroke in a patient without MP. Normal systolic BP (<130 mm Hg) was associated with an increased risk of ipsilateral ischemic strokes in patients with impaired perfusion (including MP), whereas systolic BP outside the 130 to 149 mm Hg range was associated with an increased risk of all strokes in patients without MP. Conclusion-Patients

Cerebral MR oximetry during acetazolamide augmentation: Beyond cerebrovascular reactivity in hemodynamic failure

“…Among patients with symptomatic CVD, the presence of misery perfusion has previously been linked with a greatly increased rate of subsequent ischemic stroke . Accurate detection of increased OEF in CVD patients is therefore critical for prognostication and to serve as a patient selection criterion in future clinical trials.…”

“…Among patients with symptomatic CVD, the presence of misery perfusion has previously been linked with a greatly increased rate of subsequent ischemic stroke. 9,23 Accurate detection of increased OEF in CVD patients is therefore critical for prognostication and to serve as a patient selection criterion in future clinical trials. Currently, oxygen-15 PET is the gold standard for OEF imaging, but suffers from a lack of accessibility, high expense, logistical problems arising from the 2-minute half-life of 15 O, and the risks associated with exposure to ionizing radiation.…”

“…Reduction in CVR can be measured dynamically by utilizing a flow augmentation stimulus such as acetazolamide (ACZ) . Increased OEF (CVD Stage 2) is linked to a 5‐fold increase in the 2‐year rate of ischemic stroke in patients with carotid occlusion, and may therefore have utility in disease classification and prognosis …”

“…5 Increased OEF (CVD Stage 2) is linked to a 5-fold increase in the 2-year rate of ischemic stroke in patients with carotid occlusion, and may therefore have utility in disease classification and prognosis. [6][7][8][9] Oxygen-15 positron emission tomography (PET) is considered the gold standard for OEF imaging. Its use is limited by the relatively low availability and high cost of PET, as well as the requirement for an on-site cyclotron for oxygen-15 production.…”

Carotid artery disease in post‐stroke survivors and effects of enriched environment on stroke pathology in a mouse model of carotid artery stenosis

“…Carotid artery disease (CAD) is one of the most important risk factors for ischaemic stroke . Carotid intima‐media thickness is used as a non‐invasive ultrasound marker of early atherosclerosis, which is positively and robustly related to strokes .…”