Perfusion imaging and recurrent cerebrovascular events in intracranial atherosclerotic disease or carotid occlusion

Background Large vessel disease stroke subtype carries the highest risk of early recurrent stroke. In this study we aim to look at the association between impaired perfusion and early stroke recurrence in patients with intracranial atherosclerotic disease or total cervical carotid occlusion. Methods...

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Bibliographic Details
Published in:International journal of stroke 2018-08, Vol.13 (6), p.592-599
Main Authors: Sacchetti, Daniel C, Cutting, Shawna M, McTaggart, Ryan A, Chang, Andrew D, Hemendinger, Morgan, Mac Grory, Brian, Siket, Matthew S, Burton, Tina, Thompson, Bradford, Rostanski, Sara K, Prabhakaran, Shyam, Willey, Joshua Z, Marshall, Randolph S, Elkind, Mitchell SV, Khatri, Pooja, Furie, Karen L, Jayaraman, Mahesh V, Yaghi, Shadi
Format: Article
Language:English
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Summary:Background Large vessel disease stroke subtype carries the highest risk of early recurrent stroke. In this study we aim to look at the association between impaired perfusion and early stroke recurrence in patients with intracranial atherosclerotic disease or total cervical carotid occlusion. Methods This is a retrospective study from a comprehensive stroke center where we included consecutive patients 18 years or older with intracranial atherosclerotic disease or total cervical carotid occlusion admitted with a diagnosis of ischemic stroke within 24 h from symptom onset with National Institute Health Stroke Scale  6 s mismatch volume (penumbra volume–infarct volume) of 15 ml or more. The outcome was recurrent cerebrovascular events at 90 days defined as worsening or new neurological symptoms in the absence of a nonvascular cause attributable to the decline, or new infarct or infarct extension in the territory of the affected artery. We used Cox proportional hazards models to determine the association between impaired perfusion and recurrent cerebrovascular events. Results Sixty-two patients met our inclusion criteria; mean age 66.4 ± 13.1 years, 64.5% male (40/62) and 50.0% (31/62) with intracranial atherosclerotic disease. When compared to patients with favorable perfusion pattern, patients with unfavorable perfusion pattern were more likely to have recurrent cerebrovascular events (55.6% (10/18) versus 9.1% (4/44), p 
ISSN:1747-4930
1747-4949
DOI:10.1177/1747493018764075