Afshin Borhani-Haghighi1, Mehrdad Emami2, Amin Sadeghi Vasaksi3, Abdolhamid Shariat3, Mohammad Amin Banihashemi2, Alireza Nikseresht3, Nahid Ashjazadeh3, Sadegh Izadi3, Peyman Petramfar3, Maryam Poursadegh3, Abbas Rahimi Jaberi3, Sajjad Emami4, Hamid Agheli5, Reza Nemati6, Ehsan Yaghoubi7, Mohammad Hosein Abdi8, Mohammad Mohammadi9, Peyman Jafari10, Salvador Cruz-Flores11, Randal Edgell12. 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Departments of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. 5. Neurologist, Shahidzadeh Hospital, Behbahan, Iran. 6. Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran. 7. Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran. 8. Neurologist, Motaharri Hospital, Marvdasht, Iran. 9. Neurologist, NIOC Hospital, Gachsaran, Iran. 10. Departments of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran. 11. Departments of Neurology, Texas Tech University, El Paso, USA. 12. Departments of Neurology and Psychiatry , Saint Louis University, Saint Louis, USA.
Abstract
BACKGROUND: Large artery disease (LAD) is a common cause of stroke, but a little is known regarding its role in Iranian stroke patients. The current study investigates the prevalence and risk factors for cervicocephalic arterial stenosis in the patients with ischemic stroke using digital subtraction angiography (DSA). METHODS: This was a prospective cross-sectional study performed in hospitals affiliated to Shiraz University of Medical Sciences from March 2011 to March 2013. Patients with ischemic stroke underwent noninvasive vascular and cardiac investigations to find the etiology of the stroke. Patients suspected of having large artery stenosis underwent DSA. The severity of the stenosis was calculated according to the North American Symptomatic Carotid Endarterectomy (NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial criteria. The presence of cigarette smoking, hyperlipidemia, hypertension, and diabetes mellitus were documented for all subjects. RESULTS: A total of 3703 stroke patients were identified. Of them, 342 patients (62.3%, male) underwent DSA for LAD. The mean age at the time of angiography was 66.7±10.3 years. Extracranial and intracranial arteries were involved in 305 (89.2%) and 162 (47.4%), respectively. And 301 patients (88%) had anterior circulation and 128 patients (37.4%) had posterior circulation involvement. Diabetes mellitus but not age, sex, hypertension, hyperlipidemia, or smoking was significantly associated with intracranial involvement. (P = 0.002). CONCLUSION: It can be concluded that the distribution of the large arterial atherosclerotic disease in Iran is similar to that seen in North America and Europe. Intracranial stenosis was more prevalent in diabetic patients.
BACKGROUND: Large artery disease (LAD) is a common cause of stroke, but a little is known regarding its role in Iranian strokepatients. The current study investigates the prevalence and risk factors for cervicocephalic arterial stenosis in the patients with ischemic stroke using digital subtraction angiography (DSA). METHODS: This was a prospective cross-sectional study performed in hospitals affiliated to Shiraz University of Medical Sciences from March 2011 to March 2013. Patients with ischemic stroke underwent noninvasive vascular and cardiac investigations to find the etiology of the stroke. Patients suspected of having large artery stenosis underwent DSA. The severity of the stenosis was calculated according to the North American Symptomatic Carotid Endarterectomy (NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial criteria. The presence of cigarette smoking, hyperlipidemia, hypertension, and diabetes mellitus were documented for all subjects. RESULTS: A total of 3703 strokepatients were identified. Of them, 342 patients (62.3%, male) underwent DSA for LAD. The mean age at the time of angiography was 66.7±10.3 years. Extracranial and intracranial arteries were involved in 305 (89.2%) and 162 (47.4%), respectively. And 301 patients (88%) had anterior circulation and 128 patients (37.4%) had posterior circulation involvement. Diabetes mellitus but not age, sex, hypertension, hyperlipidemia, or smoking was significantly associated with intracranial involvement. (P = 0.002). CONCLUSION: It can be concluded that the distribution of the large arterial atherosclerotic disease in Iran is similar to that seen in North America and Europe. Intracranial stenosis was more prevalent in diabeticpatients.
Authors: E M Arsava; E Ballabio; T Benner; J W Cole; M P Delgado-Martinez; M Dichgans; F Fazekas; K L Furie; K Illoh; K Jood; S Kittner; A G Lindgren; J J Majersik; M J Macleod; W J Meurer; J Montaner; A A Olugbodi; A Pasdar; P Redfors; R Schmidt; P Sharma; A B Singhal; A G Sorensen; C Sudlow; V Thijs; B B Worrall; J Rosand; H Ay Journal: Neurology Date: 2010-10-05 Impact factor: 9.910