The Impact of Intracranial Carotid Artery Calcification on the Development of Thrombolysis-Induced Intracerebral Hemorrhage

Lin, Ting Chun; Chao, Tsi-Chian; Shieh, Yao-Yang; Lee, Tsong Hai; Chang, Yen Jung; Lee, Jiann Der; Peng, Tao‐Chun; Chang, Ku Chou; Liou, Chia Wei; Chang, Tsin‐Yuan; Hung, Kuo Lun; Chang, Chien Hung

doi:10.1016/j.jstrokecerebrovasdis.2013.05.008

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…In an Asian population, carotid siphon calcium was also neither associated with sICH nor linked to functional outcome after intravenous thrombolysis [7]; however, the authors found a borderline significant increase in the occurrence of any hemorrhagic transformation. It should be noted that in this work, patients were dichotomized into no to mild calcifications vs. moderate to severe calcifications.…”

Section: Discussionmentioning

confidence: 99%

“…However, a relatively frequent complication (5–10%) is symptomatic intracerebral hemorrhage (sICH) [5, 6]. It has been previously shown, in an Asian community-based study, that moderate to severe internal carotid artery calcification is an independent risk factor for intracerebral hemorrhage after recombinant tissue plasminogen activator (rtPA) [7]. This has never been demonstrated in a western population, which is traditionally assumed to have less prevalent intracranial arterial atherosclerosis [4, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

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Intracranial Internal Carotid Artery Wall Calcification in Ischemic Strokes Treated with Thrombolysis

et al. 2017

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Background: Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications. Objectives: To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death. Methods: We included 396 consecutive ischemic stroke patients submitted to recombinant tissue plasminogen activator treatment between January 2011 and September 2014. Admission CT-scans were reviewed to calculate the Total Carotid Syphon Calcification score. Patients were followed for up to at least 6 months post-stroke or until death. Outcome measures included evaluation of recanalization on the first 24 h (transcranial color coded Doppler or angio-CT), sICH, and assessment of functional outcome at 3 months after stroke (using modified Rankin scale). Results: Carotid artery wall calcification did not predict sICH, recanalization or any good outcome. However, it was a statistically significant predictor of death (OR 1.102, 95% CI [1.004–1.211], p = 0.042). Discussion: Intracranial carotid artery calcification does not increase the risk of thrombolysis-induced sICH. Patients with higher grade of carotid artery wall calcification may have a higher mortality rate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intracranial Internal Carotid Artery Wall Calcification in Ischemic Strokes Treated with Thrombolysis

et al. 2017

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“…In addition, Tábuas-Pereira et al (34) found that AIS patients with higher grades of ICAC have higher mortality rates following IVT. There are many discrepancies among other studies and ours, such as different ICAC assessment methods; e.g., both of the studies used the Total Carotid Siphon Calcification (TCSC) score (33, 34) but different inclusion and exclusion criteria. For example, Tábuas-Pereira et al (34) included patients with posterior circulation infarctions.…”

Section: Discussionmentioning

confidence: 83%

“…Studies about the association between ICAC and the prognosis of AIS patients treated with IVT have been relatively few. Lin et al (33) showed that AIS patients with moderate to severe ICAC were more at risk of ICH but not sICH than patients with no or minor ICAC. In addition, Tábuas-Pereira et al (34) found that AIS patients with higher grades of ICAC have higher mortality rates following IVT.…”

Section: Discussionmentioning

confidence: 99%

Lack of Correlation Between Intracranial Carotid Artery Modified Woodcock Calcification Score and Prognosis of Patients With Acute Ischemic Stroke After Intravenous Thrombolysis

Zhao

et al. 2019

Front. Neurol.

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There have been few studies about the association between intracranial carotid artery calcification (ICAC) and acute ischemic stroke (AIS) prognosis after intravenous thrombolysis (IVT). We aimed to analyze the association between ICAC and prognosis (including symptomatic intracranial hemorrhage (sICH), functional outcome and death) of AIS patients treated with IVT. In this retrospective study, we consecutively included 232 AIS patients treated with IVT between April 2012 and December 2018. ICAC was evaluated using the modified Woodcock calcification visual score on non-enhanced cranial computed tomography scans. Poor functional outcome was defined as a modified Rankin Scale score > 2 at 3 months. We found that the modified Woodcock calcification score was associated with ICH, poor outcome, and death in univariable analyses on the symptomatic side and/or bilaterally. However, after adjustment for other different covariates, the results showed no significant difference. We documented that the presence and severity of ICAC did not significantly modify the beneficial effects of rtPA treatment in AIS.

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“…Sakamoto et al also reported on a patient with diabetes mellitus in whom SSR occurred after 5 months on hemodialysis, including atherosclerotic changes in the splenic artery [10]. Moreover, the severity of vascular calcification is linked not only to intracranial hemorrhage after tissue plasminogen activator in ischemic stroke [11], but also to abdominal aortic aneurysm rupture [12]. It is well known that atherosclerosis (intima lesion) induces neoangiogenesis in the adventitia, and such immature endothelial lining tissue can induce intraplaque hematomas [13].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Arterial Calcification: A Possible Etiology for Spontaneous Splenic Rupture in a Patient on Maintenance Hemodialysis

Hou¹,

Chen

Lu³

2014

Blood Purif

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The Impact of Intracranial Carotid Artery Calcification on the Development of Thrombolysis-Induced Intracerebral Hemorrhage

Cited by 12 publications

References 25 publications

Intracranial Internal Carotid Artery Wall Calcification in Ischemic Strokes Treated with Thrombolysis

Intracranial Internal Carotid Artery Wall Calcification in Ischemic Strokes Treated with Thrombolysis

Lack of Correlation Between Intracranial Carotid Artery Modified Woodcock Calcification Score and Prognosis of Patients With Acute Ischemic Stroke After Intravenous Thrombolysis

Spontaneous Arterial Calcification: A Possible Etiology for Spontaneous Splenic Rupture in a Patient on Maintenance Hemodialysis

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