Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome.
- Author:
Jihoon KANG
1
;
Tai Hwan PARK
;
Kyung Bok LEE
;
Jong Moo PARK
;
Youngchai KO
;
Soo Joo LEE
;
Keun Sik HONG
;
Yong Jin CHO
;
Ji Sung LEE
;
Juneyoung LEE
;
Byung Chul LEE
;
Kyung Ho YU
;
Dae Hyun KIM
;
Jae Kwan CHA
;
Jun LEE
;
Myung Suk JANG
;
Moon Ku HAN
;
Hee Joon BAE
Author Information
1. Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea. braindoc@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Cerebrovascular occlusion;
Stroke;
Cerebral arteries;
Magnetic Resonance Imaging
- MeSH:
Basilar Artery;
Carotid Artery, Internal;
Cerebral Arteries;
Cerebral Infarction*;
Cerebrovascular Disorders;
Constriction, Pathologic;
Hospital Distribution Systems;
Humans;
Magnetic Resonance Imaging;
Middle Cerebral Artery;
Prevalence*;
Prognosis;
Republic of Korea;
Retrospective Studies;
Stroke;
Vertebral Artery
- From:Journal of Stroke
2014;16(1):36-43
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Symptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known. METHODS: We retrospectively identified 3,451 patients hospitalized because of ischemic stroke within 24 hours of symptom onset at 9 stroke centers in South Korea. Patients who did not undergo magnetic resonance imaging were excluded. SYSO was defined as stenosis or occlusion of cerebral arteries with relevant ischemic lesions in the corresponding arterial territory. The number, location, and severity of SYSOs and their effects on functional outcome were analyzed. RESULTS: In total, 1,929 of 3,057 subjects (63.1%) had SYSO. The most frequently affected vessels were the middle cerebral artery (34.6%), extracranial internal carotid artery (14%), vertebral artery (12.4%), and basilar artery (8.7%). SYSO predicted poor outcome on the modified Rankin Scale 3-6 (odds ratio, 1.77; 95% confidence interval, 1.46-2.15) with adjustments. Involvement of 2 or more vessels was observed in 30.6% of patients with SYSO and independently increased the risk of poor outcome (odds ratio, 2.76; 95% confidence interval, 2.12-3.59). The severity of SYSO was associated with outcome and showed a significant dose-response trend (P<0.001). The effect of SYSO on outcome did not significantly differ by individual arterial location (P for contrast=0.21). CONCLUSIONS: Approximately 60% of patients with acute ischemic stroke had SYSO, and the severity and number were inversely correlated with outcome. The results suggest that SYSO could predict stroke outcome.
