Symptomatic intracranial stenosis: A university hospital-based ultrasound study

Viaro, Federica; Farina, Filippo; Onofri, Angelo; Meneghetti, Giorgio; Baracchini, Claudio

doi:10.1016/j.permed.2012.02.004

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…Genetic differences may play some role, as it has been suggested that during the expansion of the human population, those who settled in Europe have acquired a stroke-suppressor genotype that increases their resistance against atherogenesis, but with protection confined to the intracranial large arteries [18]. In our study, the prevalence seems close to that of the Hispanics with 11% and to Italians with 20.2% [19]. This may be explained by common genetic and environmental factors among Egyptians and other Mediterranean populations.…”

Section: Discussionsupporting

confidence: 58%

Prevalence of Intracranial Atherosclerosis among Patients with Coronary Artery Disease: A 1-Year Hospital-Based Study

Abd-Allah

Kassem²,

Hashad³

et al. 2014

Eur Neurol

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Background: There are limited data on the prevalence of intracranial atherosclerotic disease (ICAD) in patients with coronary artery disease (CAD) worldwide and especially among Egyptians. The purpose of the present study was to determine the prevalence and correlates of ICAD in patients with CAD. Methods: From January 1, 2012 to January 1, 2013, we recruited 118 consecutive patients who had ischemic heart disease. All patients were assessed for vascular risk factors and the existence of stroke or transient ischemic attack (TIA) and were evaluated by extracranial and transcranial color-coded sonography. All patients underwent coronary angiography. Clinical, echocardiographic and angiographic variables were tested by univariate and multivariate analysis. Results: Out of 118 consecutive patients with CAD, intracranial disease was detected in 14 patients (11.9%). Eight patients (6.8%) had stenosis >50%, while 6 patients (5.1%) had stenosis <50%. The univariate analysis showed that the strongest variables associated with ICAD were the presence of recent or old stroke or TIA, followed by moderate or severe extracranial stenosis, and multivessel or left main CAD. Conclusion: We observed low prevalence (6.8%) of high-grade ICAD among Egyptian patients with CAD. Multivessel or left main CAD and moderate-to-severe extracranial carotid stenosis were the strongest predictors for the existence of ICAD among CAD patients.

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Section: Discussionsupporting

confidence: 58%

Prevalence of Intracranial Atherosclerosis among Patients with Coronary Artery Disease: A 1-Year Hospital-Based Study

Abd-Allah

Kassem²,

Hashad³

et al. 2014

Eur Neurol

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“…22,23 In Western countries, ICAS has historically been poorly studied and may be underestimated compared to extracranial lesions. 18,24,25 In 1995, Sacco et al found 8% of intracranial atherosclerosis in a stroke population of 438 patients (35% Black, 46% Hispanic, and 19% White). The rate of extracranial atherosclerosis was similar between ethnic groups; however, intracranial lesions were more frequent in Blacks and Hispanics (OR: 7.8; 95% CI: 1.04-57.7).…”

Section: Discussionmentioning

confidence: 99%

High prevalence of intracranial arterial stenosis among acute ischemic stroke patients in a Brazilian center: a transcranial color-coded duplex sonography study

Rocha,

Zotin,

Santos

et al. 2024

Arq Neuropsiquiatr

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Background There is limited data available regarding the prevalence of intracranial arterial stenosis (ICAS) among acute ischemic stroke (AIS) patients in Brazil and Latin America. Objective The present study sought to investigate the frequency and predictors of ICAS among patients with AIS or transient ischemic attack (TIA) in a Brazilian center, with transcranial color-coded duplex sonography (TCCS) technique. Methods Consecutive AIS and TIA patients, admitted to an academic public comprehensive stroke center in Brazil from February to December 2014, evaluated by TCCS were prospectively selected. Vascular narrowings > 50% were considered as ICAS, based on ultrasound criteria previously defined in the literature. Results We assessed 170 consecutive patients with AIS or TIA, of whom 27 (15.9%) were excluded due to an inadequate transtemporal acoustic bone window. We confirmed ICAS in 55 patients (38.5%). The most common location was the proximal segment of the middle cerebral artery (28.2%), followed by the vertebral (15.4%), posterior cerebral (13.6%), terminal internal carotid (9.1%) and basilar (8.2%) arteries. On multivariate models adjusting for potential confounders, systolic blood pressure (OR: 1.03, 95%CI: 1.01–1.04; p = 0.008) was independently associated with ICAS. Conclusion We found significant ICAS in approximately ⅓ of patients admitted with symptoms of AIS or TIA in a public tertiary academic stroke center in Brazil. The TCCS is an accessible and noninvasive technique that can be used to investigate the presence of moderate and severe ICAS, especially in patients who cannot be exposed to more invasive exams, such as the use of intravenous contrast agents.

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“…Stroke is a leading cause of morbidity and mortality worldwide resulting in an estimated 4.4 million deaths each year [ 1 ]. Large vessel intracranial atherosclerotic disease (ICAD) is believed to have a higher frequency among the South Asians [ 2 – 7 ] with one study [ 8 ] reporting it to be responsible for at least 30–50% strokes among the Asian population.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic TCD for intracranial stenosis in acute stroke patients: experience from a tertiary care stroke center in Karachi, Pakistan

et al. 2015

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BackgroundStroke is a common cause of morbidity and mortality around the world. Intracranial large artery atherosclerosis (ICAD) is a frequent etiology of stroke in the South Asian population. There is a need for widely available screening tools to identify patients that are at high risk of stroke due to ICAD for aggressive risk management. This study describes the experience of using the transcranial Doppler (TCD) as a screening tool for this purpose at a tertiary care hospital in a developing country.Methods86 Patients admitted with stroke due to ICAD underwent TCD for six arteries (Right and left middle cerebral arteries, right and left anterior cerebral arteries, right and left posterior cerebral arteries) in addition to the magnetic resonance angiography (MRA) that is done routinely at the stroke center. Arteries were labeled with either <50 or >50% stenosis by TCD using two separate criteria. These findings were compared with those from the MRA which was used as the gold standard. The proportion of patients that had complete exams (all six arteries insonated by TCD) was reported. The success rate of each TCD criteria in detecting arteries with >50% stenosis was also calculated.ResultsThere was an attempt to visualize 516 arteries (86 patients with 6 arteries each) of which 375 (72.7%) were successfully insonated. 38 of the 86 (55.8%) patients had complete examinations. MRA reported 43 (8.3%) arteries as stenosed >50%. The TCD did not categorize any artery as stenosed using either criterion and hence failed to classify any stenosed artery correctly. The positive predictive and sensitivity was 0 for this study and the negative predictive value was 93.3%.ConclusionsThis study indicates the poor sensitivity of TCD to be a reliable screening tool for the presence of ICAD in the South Asian population in a real life clinical setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1289-3) contains supplementary material, which is available to authorized users.

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Symptomatic intracranial stenosis: A university hospital-based ultrasound study

Cited by 4 publications

References 10 publications

Prevalence of Intracranial Atherosclerosis among Patients with Coronary Artery Disease: A 1-Year Hospital-Based Study

Prevalence of Intracranial Atherosclerosis among Patients with Coronary Artery Disease: A 1-Year Hospital-Based Study

High prevalence of intracranial arterial stenosis among acute ischemic stroke patients in a Brazilian center: a transcranial color-coded duplex sonography study

Diagnostic TCD for intracranial stenosis in acute stroke patients: experience from a tertiary care stroke center in Karachi, Pakistan

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