scholarly journals Risk Factors of New Cerebral Infarctions After Endovascular Treatment for Basilar Artery Stenosis Based on High-Resolution Magnetic Resonance Imaging

2021 ◽  
Vol 11 ◽  
Author(s):  
Jichang Luo ◽  
Long Li ◽  
Tao Wang ◽  
Kun Yang ◽  
Yao Feng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Stenosis ◽  
Plaque Burden ◽  
Negative Group ◽  
Resonance Imaging ◽  
Positive Group ◽  
Basilar Artery Stenosis

Objective: The current study aims to analyze the risk factors of new cerebral infarctions in the distribution of basilar artery (BA) detected by diffusion-weighted imaging (DWI) after endovascular treatment in patients with severe BA stenosis.Methods: Data was collected from the electronic medical records of patients with severely atherosclerotic basilar artery stenosis (≥70%) who underwent endovascular treatment. The plaque characteristics, including the plaque distribution, plaque burden, plaque enhancement index, remodeling ratio, and stenosis degree, were evaluated qualitatively and quantitatively using high-resolution magnetic resonance imaging (HR-MRI) and digital subtraction angiography (DSA). The characteristics of the procedure, such as the type of treatment, balloon diameter, balloon length, stent diameter, and stent length, were analyzed.Results: A total of 107 patients with severe basilar artery stenosis (≥70%) who underwent endovascular treatment were enrolled. The study participants included 77 men and 30 women, with an average age of 61.6 ± 8.1 years. The rate of postoperative new cerebral infarctions was 55.1% (59/107), of which 74.6% (44/59) were caused by artery-to-artery embolism, 6.8% (4/59) due to perforator occlusion, and 18.6% (11/59) were caused by a mixed mechanism. Twelve of 59 patients had ischemic events, with nine cases of stroke and three cases of transient ischemic attacks (TIA). The plaque burden in the DWI-positive group was significantly larger than that in the DWI-negative group (3.7% vs. −8.5%, p = 0.016). Positive remodeling was more common in the DWI-positive group than in the DWI-negative group (35.6% vs. 16.7%, p = 0.028). Smoking was inversely correlated with the rate of new cerebral infarctions (odds ratio, 0.394; 95% confidence interval, 0.167–0.926; p = 0.033).Conclusion: The plaque characteristics are not associated with new cerebral infarctions in the distribution of BA, although a large plaque burden and positive remodeling are more likely to appear in patients with new cerebral infarctions after BA stenting, which warrants further studies with a larger sample size. As for smoking, the inverse correlation with new cerebral infarctions in the BA territory needs large-scale prospective randomized controlled trials to verify.

High Risk of Recurrent Ischemic Events Among Patients With Deferred Intracranial Angioplasty and Stent Placement for Symptomatic Intracranial Atherosclerosis

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. 334-343 ◽  
Author(s):  
Osman Kozak ◽  
Nauman Tariq ◽  
M. Fareed K. Suri ◽  
Robert A. Taylor ◽  
Adnan I. Qureshi
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Stent Placement ◽  
Recurrent Events ◽  
Artery Stenosis ◽  
Intracranial Stenosis ◽  
High Grade ◽  
Best Medical Treatment ◽  
Basilar Artery Stenosis ◽  
Ischemic Events

Abstract BACKGROUND: Intracranial angioplasty with or without stent placement has been performed to treat patients with recurrent cerebral ischemic events despite best medical therapy or those with high-grade stenosis. OBJECTIVE: To evaluate early recurrent stroke/transient ischemic attack rates in a cohort of patients with symptomatic >50% intracranial stenosis in whom intracranial angioplasty and stent placement was initially deferred. METHODS: All patients presenting to 2 academic hospitals with symptomatic intracranial disease between 2006 and 2008 who underwent catheter angiography were identified. Patients with complete intracranial occlusion or stenosis less than 50% stenosis were excluded (n = 14). RESULTS: Thirty-one patients met the study criteria. Sixteen (52%) patients were on antiplatelet medications at the time of the initial event, and 2 patients were also on anticoagulant medications. Six patients (19%) underwent intracranial angioplasty and/or stent placement with their initial diagnostic angiogram. Twenty-five patients (81%) had endovascular treatment deferred for best medical treatment in the interim period. Among the 25 patients who were kept on medical management, 14 (56%) were readmitted with recurrent ischemic events in the distribution of the target artery within a median of 28 days (range, 1-243 days). Recurrent events occurred within 1 week in 8 (57%) patients, between 7 days and 1 month in 4 (29%) patients, 1 to 3 months in 1 (7%) patient, and after 3 months in 1 (7%) patient. Recurrent ischemic events were observed in all 5 patients with basilar artery stenosis and in 13 of 17 patients with severity of stenosis ≥70%. CONCLUSION: A high rate of recurrent ischemic events was observed among patients in whom endovascular treatment was deferred, particularly those with basilar artery stenosis and those with high-grade stenosis. This information would be beneficial in decision making for timing of the endovascular treatment among patients with symptomatic intracranial stenosis.

Endovascular Treatment of Symptomatic Radiation-Induced Basilar Artery Stenosis 25 Years after Medulloblastoma

2011 ◽  
Vol 42 (03) ◽  
pp. 87-89
Author(s):  
P. Gölitz ◽  
F. Knossalla ◽  
S. Ott ◽  
T. Struffert ◽  
A. Doerfler
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Stenosis ◽  
Basilar Artery Stenosis ◽  
Radiation Induced

scholarly journals High-Resolution Vessel Wall Magnetic Resonance Imaging of Small Unruptured Intracranial Aneurysms

2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Łukasz Zwarzany ◽  
Ernest Tyburski ◽  
Wojciech Poncyljusz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Resonance Imaging ◽  
Aneurysm Wall ◽  
Conventional Risk Factors

Background: We decided to investigate whether aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR VW-MRI) coexists with the conventional risk factors for aneurysm rupture. Methods: We performed HR VW-MRI in 46 patients with 64 unruptured small intracranial aneurysms. Patient demographics and clinical characteristics were recorded. The PHASES score was calculated for each aneurysm. Results: Of the 64 aneurysms, 15 (23.4%) showed wall enhancement on post-contrast HR VW-MRI. Aneurysms with wall enhancement had significantly larger size (p = 0.001), higher dome-to-neck ratio (p = 0.024), and a more irregular shape (p = 0.003) than aneurysms without wall enhancement. The proportion of aneurysms with wall enhancement was significantly higher in older patients (p = 0.011), and those with a history of prior aneurysmal SAH. The mean PHASES score was significantly higher in aneurysms with wall enhancement (p < 0.000). The multivariate logistic regression analysis revealed that aneurysm irregularity and the PHASES score are independently associated with the presence of AWE. Conclusions: Aneurysm wall enhancement on HR VW-MRI coexists with the conventional risk factors for aneurysm rupture.

Accuracy of Computed Tomography and Magnetic Resonance Imaging for Detection of Pathologic Risk Factors in Patients Diagnosed with Retinoblastoma

2021 ◽  
pp. 1-7
Author(s):  
Damrong Wiwatwongwana ◽  
Pichaya Kulniwatcharoen ◽  
Pongsak Mahanupab ◽  
Pannee Visrutaratna ◽  
Atchareeya Wiwatwongwana
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Resonance Imaging
Sign in / Sign up

Export Citation Format

Share Document