scholarly journals Blood biomarkers of progressive atherosclerosis and restenosis after stenting of symptomatic intracranial artery stenosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melanie Haidegger ◽  
Markus Kneihsl ◽  
Kurt Niederkorn ◽  
Hannes Deutschmann ◽  
Harald Mangge ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Artery Stenosis ◽  
University Hospital ◽  
Intracranial Artery ◽  
Blood Biomarkers ◽  
Laboratory Parameters ◽  
Lymphocyte Ratio ◽  
Intracranial Artery Stenosis

AbstractIn-stent restenosis (ISR) represents a major complication after stenting of intracranial artery stenosis (ICAS). Biomarkers derived from routine blood sampling including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) have been associated with progressive atherosclerosis. We investigated the role of CRP, NLR, PLR and MPV on the development of intracranial ISR and recurrent stroke risk. We retrospectively included all patients who had undergone stenting of symptomatic ICAS at our university hospital between 2005 and 2016. ISR (≥ 50% stenosis) was diagnosed by regular Duplex sonography follow-up studies and confirmed by digital subtraction angiography or computed tomography angiography (mean follow-up duration: 5 years). Laboratory parameters were documented before stenting, at the time of restenosis and at last clinical follow-up. Of 115 patients (mean age: 73 ± 13 years; female: 34%), 38 (33%) developed ISR. The assessed laboratory parameters did not differ between patients with ISR and those without (p > 0.1). While ISR was associated with the occurrence of recurrent ischemic stroke (p = 0.003), CRP, NLR, PLR and MPV were not predictive of such events (p > 0.1). Investigated blood biomarkers of progressive atherosclerosis were not predictive for the occurrence of ISR or recurrent ischemic stroke after ICAS stenting during a 5-year follow-up.

scholarly journals Associations of the neutrophil to lymphocyte ratio with intracranial artery stenosis and ischemic stroke

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang-Yu Huang ◽  
Fu-Rong Sun ◽  
Jian-Jun Yin ◽  
Ya-Hui Ma ◽  
Hong-Qi Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mediation Analysis ◽  
Inflammatory Marker ◽  
Artery Stenosis ◽  
Neutrophil To Lymphocyte Ratio ◽  
High Risk Population ◽  
Intracranial Artery ◽  
Lymphocyte Ratio ◽  
Intracranial Artery Stenosis ◽  
Risk Predictors

Abstract Background The neutrophil-to-lymphocyte ratio (NLR) has emerged as an inflammatory marker. However, the associations of NLR with intracranial artery stenosis (ICAS) and ischemic stroke remain unclear. This study aimed to examine the associations of NLR with ICAS and ischemic stroke among a large and high-risk population. Methods Participants with records of clinical characteristics were prospectively recruited from the Neurology Department and Health & Physical Examination Center of Qingdao Municipal Hospital. Logistic regression analysis was used to examine the associations of NLR with ICAS and ischemic stroke. Moreover, we also conducted parametric mediation analysis to estimate the effect of NLR on the risk of ischemic stroke mediated through ICAS. Results A total of 2989 participants were enrolled in this study. After adjusting for covariates, NLR (OR = 1.125, 95%CI 1.070–1.183) and ICAS (OR = 1.638, 95%CI 1.364–1.967) were significantly associated with ischemic stroke. Compared with the first quartile NLR, the second, third and fourth quartiles NLR were independent risk predictors for ischemic stroke (P for trend < 0.001); the third and fourth quartiles were independent predictors for ICAS (P for trend < 0.001). The mediation analysis showed that ICAS partially mediated the association between NLR and ischemic stroke, accounting for 14.4% of the total effect (P < 0.001). Conclusions NLR was significantly associated with ICAS and ischemic stroke. Besides, ICAS partially mediated the association between NLR and ischemic stroke.

scholarly journals Bypass Surgery for Ischemic Stroke Caused by Intracranial Artery Stenosis or Occlusion

2018 ◽  
Vol 4 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Ismatullah Soufiany ◽  
Khalil Ahmad Hijrat ◽  
Spina Soufiany ◽  
Lukui Chen
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Vegetative State ◽  
Superficial Temporal Artery ◽  
Case Series ◽  
Temporal Artery ◽  
Artery Stenosis ◽  
Intracranial Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

Surgical revascularization may be beneficial in patients with ischemic stroke caused by intracranial stenosis or occlusion who are ineligible for thrombolysis. Objective To evaluate the outcome of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in ischemic stroke caused by intracranial artery stenosis or occlusion. Methods We retrospectively studied successive case series of 19 patients who underwent surgical treatment between 2013–2017 of STA-MCA bypass. Surgical procedure was performed for the patients with acute ischemic stroke who were ineligible for thrombolysis. Results Of the 19 patients enrolled, symptom aggravation occurred during medical treatment, the patients were ineligible for thrombolysis despite being within 8 hours of symptom onset. Bypass significantly improved National Institutes of Health Stroke Scale scores, mean patient age was 78.05 years (range, 39–78 y). However, male 11 (57.95%) out of nineteen patients were presented with left-sided-lesions while female 8 (42%) had right-sided lesions with significant infarction growth by diffusion weighted imaging achieved, after surgical maneuver. No major complications occurred intraoperatively, in contrast to 2 (10.5%) minor manifestation were suffering minor complications probably they included the remote infarction (posterior cerebral artery territory). Pooled analysis with our patients showed a significant neurological improvement and a good outcome in 13 (68.4%) patients without hemorrhage or any other complication, 6 (31.6%) patients with unfavorable outcome (severe disability 2; vegetative state 4, non of them are died 0;). Conclusion STA-MCA bypass may be beneficial to patients with acute stroke or stenosis in progress who are ineligible for medical therapy. Furthermore, it appears safe when the infarction is small. These findings indicate that STA-MCA bypass could be considered as a treatment option in selected patients with ischemic stroke caused by intracranial stenosis or occlusion.

Abstract T P101: Low Serum Eicosapentaenoic Acid- Arachidonic Acid Ratio is Associated With Intracranial Stenosis in Patients With Acute Ischemic Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yuko Abe ◽  
Ryoichi Otsubo ◽  
Sho Murase ◽  
Kenichiro Nakazawa ◽  
Kazuo Kitagawa
Keyword(s):  
Risk Factors ◽  
Arachidonic Acid ◽  
Ischemic Stroke ◽  
Eicosapentaenoic Acid ◽  
Acute Ischemic Stroke ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Stroke Subtype ◽  
Fa Composition ◽  
Intracranial Artery Stenosis

Purpose: A low ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) has been associated with atherosclerotic disease. Few studies investigate the association of serum fatty acid (FA) composition with the acute ischemic stroke so far. Our aim of this study is to evaluate the relationships between FA composition and stroke subtypes, extra-/intracranial atherosclerotic stenoses, and other cerebrovascular indicators Methods: This study included 154 consecutive patients who were admitted to our hospital because of acute ischemic stroke between April 2011 and March 2012. We examined the FA composition and classical vascular risk factors. We conducted brain MRI/MRA, carotid ultrasonogram, transthoracic echocardiogram, 24hr Holter electrocardiogram, ankle brachial index (ABI) and pulse wave velocity (PWV) in order to evaluate the severity of atherosclerotic change, stroke subtype, and cardiovascular status. Results: The mean value of EPA/AA was 0.33±0.22 in all patients with acute cerebral infarction. The 154 patients in this study (mean age 71 years) were categorized as follows; large artery atherosclerosis (LA; n=57), small artery occlusion (SA; n=48), cardiogenic embolism (CE; n=18), and others (n=31). We found intracranial artery stenosis greater than 50% in 70 patients (45%). The intracranial artery stenosis was associated with low EPA/AA ratio (P=0.013) and low EPA concentration (P=0.013). This association remained significant (P<0.05) after controlling for classical atherosclerotic risk factors. We could not find a significant correlation between FA composition and stroke subtype. However, there was a tendency for the EPA/AA ratio of LA patients to be the lowest among all subtype groups. The EPA/AA ratio was not associated with ABI, PWV, prevalence of arrhythmia, or cardiac function. Conclusions: A low EPA/AA ratio was significantly associated with intracranial stenosis in patients with acute ischemic stroke. This study shows the EPA/AA ratio might be an important marker to reflect the cerebral artery stenosis.

Plasma Levels of Apolipoprotein E and Risk of Intracranial Artery Stenosis in Acute Ischemic Stroke Patients

2013 ◽  
Vol 62 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Yong-Jae Kim ◽  
Seung-Min Lee ◽  
Hyun-Ji Cho ◽  
Hyun Ju Do ◽  
Chang Hyung Hong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Apolipoprotein E ◽  
Acute Ischemic Stroke ◽  
Plasma Levels ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Stroke Patients ◽  
Intracranial Artery Stenosis

scholarly journals Challenge of Identifying the Cause of Intracranial Artery Stenosis in Patients With Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (3) ◽  
Author(s):  
Sylvain Lanthier ◽  
Céline Odier ◽  
Sophia Sundararajan ◽  
Daniel Strbian
Keyword(s):  
Ischemic Stroke ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

scholarly journals Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke

Stroke ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 2294-2300 ◽  
Author(s):  
Bihong Zhu ◽  
Huihui Liu ◽  
Yuesong Pan ◽  
Jing Jing ◽  
Hao Li ◽  
...  
Keyword(s):  
Recurrent Stroke ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

scholarly journals Treatment and Short-Term Follow-up of Symptomatic Atherosclerotic Intracranial Artery Stenosis by Stent-Assisted Angioplasty

2003 ◽  
Vol 9 (2) ◽  
pp. 153-162 ◽  
Author(s):  
Miao Zhongrong Ling Feng ◽  
Li Shengmao ◽  
Zhu Fengshui ◽  
Hua Yang ◽  
Wang Moli
Keyword(s):  
Treatment Protocol ◽  
Artery Stenosis ◽  
Minor Stroke ◽  
Intracranial Artery ◽  
Technical Success ◽  
Short Term ◽  
Female Ratio ◽  
Intracranial Artery Stenosis ◽  
Basilar Arteries

Atherosclerotic intracranial artery stenosis can cause hypoperfusion of brain tissues and embolus formation, causing stroke. Conservative medical treatment seemed to have little effect on the natural history and prevent the stroke attack caused by artery stenosis. The purpose of stent-assisted angioplasty is to reconstruct the damaged vessels: the indications, feasibility, effectiveness, complications and follow-up for this new treatment method are discussed. A series of 32 cases with symptomatic intracranial artery stenosis were accepted from 1998 to 2002. The mean age was 42 yrs (31∼76 yr), male/female ratio=23/9. All patients were refractory to optimal medical therapy. Lesions included 12 middle cerebral arteries (37.5%), six basilar arteries (18.75%), three distal ICAs (9.38%) and 12 intracranial Vas (37.5%). All patients were treated by methods of transluminal stent-assisted angioplasty under general anesthesia. Patients were premedicated with Aspirin (300mg/per day) and Ticlopidine (250mg/per day), this was continued for six weeks after the procedure. Medical history, anamnesis, and treatment protocol were reviewed and evaluated retrospectively, short-term follow-up (2mths ∼ 1 yr) was also obtained. Primary clinical presentations were TIAs (21/32, 65.63%), minor stroke (8/32, 25%) and severe stroke (3/32, 9.38%). 31 cases (96.86%) were successfully implanted with coronary stents within the stenosed vessels; technical success rate was 96.86%. Instant angiographic results showed the stenosed extent had decreased from 72.36%±5.69 to 10.16%±6.94. One vessel ruptured during the procedure, the patient recovered after surgical repair of the ruptured vessel. Clinical follow-up demonstrated symptoms resolved in most patients (30/32, 93.75%) within the follow-up period, two cases with MCA stenosis had TIAs within two months after the procedure. 12 cases accepted angiographic follow-up. Velocities of stented vessels of five cases (5/21, 23.81%) increased compared to instant results, suggesting restenosis, three of them were confirmed by angiography which included two cases with MCA stenosis (figure 3) and one with distal VA, one of the five cases had recurred TIAs. With the newer generation of coronary stent, this technique seemed safe, feasible and effective to prevent stroke attack, but the indication is very important for the technical success. Restenosis remains a common problem as with coronary stenting. Long-term follow-up will be needed.

scholarly journals Prevalence of Intracranial Artery Stenosis in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital of China

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Sandip Kumar Jaiswal ◽  
Yan Fuling ◽  
Min Li
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Posterior Circulation ◽  
Artery Stenosis ◽  
Care Hospital ◽  
Intracranial Artery ◽  
Anterior Circulation ◽  
Intracranial Artery Stenosis

Introduction: Intracranial artery stenosis is the most common cause of acute ischemic stroke, especially among people in Asia. About its epidemiology, however little is understood. The goal of our research is to establish the prevalence of intracranial artery stenosis in patients with acute ischemic stroke in a tertiary care hospital. Methods: A descriptive cross-sectional study was done in 1006 acute ischemic stroke patients at Affiliated Zhongda Hospital, School of Medicine, Southeast University China from May 2018 to May 2019. Ethical approval was taken from the Ethical review committee of the institution. A convenient sampling method was done. Intracranial artery stenosis was diagnosed when evidence of acute ischemic stroke was found in the territory of approximately 2 50% stenosis identified by Transcranial Doppler ultrasound and confirmed by magnetic resonance angiography or computed tomography. Statistical analysis was done using the Statistical Package for the Social Sciences version 20. Results: The prevalence of intracranial artery stenosis was found in 331 (32.90%) patients at 95% Confidence interval (0.24-0.42%). Among 331 cases the anterior circulation artery stenosis was present on 201 (19.98%) patients, followed by posterior circulation artery stenosis on 80 (7.95%) patients, then anterior plus posterior circulation artery stenosis on 50 (4.97%) patients. Conclusions: Intracranial artery stenosis is one of the most causes of acute ischemic stroke in China. The proportion of anterior circulation artery stenosis was higher than that in the posterior circulation.

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