Pietro Caliandro1, Giuseppe Reale2, Andrew M Demchuk3, Valeria Caso4, Anita Arsovska5, Chiara Iacovelli6, Silvia Giovannini7, Paolo Maria Rossini2. 1. Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Rome, Italy. pietro.caliandro@policlinicogemelli.it. 2. Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy. 3. Hotchkiss Brain Institute, Department of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Canada. 4. Division of Cardiovascular Medicine, Stroke Unit, University of Perugia, Perugia, Italy. 5. University Clinic of Neurology, Skopje, Macedonia. 6. Fondazione Don Carlo Gnocchi Onlus, Milan, Italy. 7. Unità Operativa Complessa Riabilitazione 2, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Rome, Italy.
Abstract
INTRODUCTION: The objective of this single-center pilot study was to assess if symptomatic intracranial atherosclerotic disease (ICAD) ultrasound features change through the 2 years after acute ischemic stroke or TIA, being ICAD a relevant cause of acute ischemic stroke or TIA, linked to high rates of recurrent stroke. METHODS: We consecutively enrolled 48 patients with acute ischemic stroke or TIA with symptomatic ICAD detected by transcranial color-coded duplex sonography (TCCS) and confirmed by MR-angiography and/or CT-angiography. We set a neurosonological and clinical follow-up at 3, 6, 12, and 24 months (T0, T1, T2, T3, and T4). RESULTS: We observed that the hemodynamic effect of the stenosis changed during the 2-year follow-up, as revealed by the modifications of Peak Systolic Velocity (PSV) (Friedman-ANOVA test, p < 0.001). The pairwise post-hoc analysis showed a statistically significant difference between PSV at T0 and PSV at T3 (p = 0.005) and between PSV at T0 and PSV at T4 (p < 0.001) being PSV at T3 and T4 lower than PSV at T0. Seven patients had a new event in the first 12 months. CONCLUSIONS: The high rate of recurrent stroke or death among ICAD patients seems to be independent of progressive arterial narrowing. A wide multicenter follow-up study is needed in order to identify the factors that, alongside the hemodynamic features, contribute to the high risk of recurrent stroke among patient with symptomatic ICAD.
INTRODUCTION: The objective of this single-center pilot study was to assess if symptomatic intracranial atherosclerotic disease (ICAD) ultrasound features change through the 2 years after acute ischemic stroke or TIA, being ICAD a relevant cause of acute ischemic stroke or TIA, linked to high rates of recurrent stroke. METHODS: We consecutively enrolled 48 patients with acute ischemic stroke or TIA with symptomatic ICAD detected by transcranial color-coded duplex sonography (TCCS) and confirmed by MR-angiography and/or CT-angiography. We set a neurosonological and clinical follow-up at 3, 6, 12, and 24 months (T0, T1, T2, T3, and T4). RESULTS: We observed that the hemodynamic effect of the stenosis changed during the 2-year follow-up, as revealed by the modifications of Peak Systolic Velocity (PSV) (Friedman-ANOVA test, p < 0.001). The pairwise post-hoc analysis showed a statistically significant difference between PSV at T0 and PSV at T3 (p = 0.005) and between PSV at T0 and PSV at T4 (p < 0.001) being PSV at T3 and T4 lower than PSV at T0. Seven patients had a new event in the first 12 months. CONCLUSIONS: The high rate of recurrent stroke or death among ICAD patients seems to be independent of progressive arterial narrowing. A wide multicenter follow-up study is needed in order to identify the factors that, alongside the hemodynamic features, contribute to the high risk of recurrent stroke among patient with symptomatic ICAD.
Authors: Limin Zhao; Kristian Barlinn; Vijay K Sharma; Georgios Tsivgoulis; Luis F Cava; Spyros N Vasdekis; Hock Luen Teoh; Nikos Triantafyllou; Bernard P L Chan; Arvind Sharma; Konstantinos Voumvourakis; Elefterios Stamboulis; Maher Saqqur; Mark R Harrigan; Karen C Albright; Andrei V Alexandrov Journal: Stroke Date: 2011-09-29 Impact factor: 7.914
Authors: E Feldmann; J L Wilterdink; A Kosinski; M Lynn; M I Chimowitz; J Sarafin; H H Smith; F Nichols; J Rogg; H J Cloft; L Wechsler; J Saver; S R Levine; C Tegeler; R Adams; M Sloan Journal: Neurology Date: 2007-04-04 Impact factor: 9.910
Authors: Giuseppe Reale; Aurelia Zauli; Giuseppe La Torre; Alice Mannocci; Michael V Mazya; Marialuisa Zedde; Silvia Giovannini; Marco Moci; Chiara Iacovelli; Pietro Caliandro Journal: Ther Adv Neurol Disord Date: 2022-08-05 Impact factor: 6.430
Authors: Jiayu Xiao; Shlee S Song; Konrad H Schlick; Shuang Xia; Tao Jiang; Tong Han; Robert J Jackson; Marcio A Diniz; Oana M Dumitrascu; Marcel M Maya; Patrick D Lyden; Debiao Li; Qi Yang; Zhaoyang Fan Journal: Neuroradiol J Date: 2021-06-23