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Larger A1/M1 Diameter Ratio Predicts Embolic Anterior Cerebral Artery Territorial Stroke
BACKGROUND AND PURPOSE—In contrast to middle cerebral artery territory strokes, anterior cerebral artery strokes (ACAS) occur rarely. The low frequency of ACAS, in relation to middle cerebral artery territory strokes, may be explained by differences in ACA and middle cerebral artery anatomy influenc...
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| Published in: | Stroke (1970) 2014-09, Vol.45 (9), p.2798-2800 |
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| container_issue | 9 |
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| container_title | Stroke (1970) |
| container_volume | 45 |
| creator | Shoamanesh, Ashkan Masoud, Hesham Furey, Katrina Duerfeldt, Kaylyn Lau, Helena Romero, Jose R Pikula, Aleksandra Teal, Philip Nguyen, Thanh N Kase, Carlos S Babikian, Viken L |
| description | BACKGROUND AND PURPOSE—In contrast to middle cerebral artery territory strokes, anterior cerebral artery strokes (ACAS) occur rarely. The low frequency of ACAS, in relation to middle cerebral artery territory strokes, may be explained by differences in ACA and middle cerebral artery anatomy influencing their respective flow-directed embolism rates. We aimed to determine whether variability in ACA anatomy, and in particular A1 segment diameter, is associated with embolic ACAS.
METHODS—Consecutive patients admitted to Boston Medical Center with embolic ACAS were reviewed. Ipsilateral and contralateral A1 diameters, M1 diameters, and terminal internal carotid artery bifurcation angles were measured from computed tomographic angiography and MRI angiography images. We compared these measurements between cases of ACAS and consecutive cases of embolic middle cerebral artery territory strokes.
RESULTS—The study comprised 55 individuals (27 ACAS, 28 middle cerebral artery territory strokes) with mean age of 69 years. In multivariate regression analysis, larger ipsilateral A1 diameters (odds ratio per 1 mm increment8.5; 95% confidence interval, 1.4–53.3) and ipsilateral A1/M1 diameter ratio (odds ratio per 10% increment1.8; 95% confidence interval, 1.2–2.9) were associated with ACAS, whereas larger ipsilateral M1 diameters was protective for ACAS (odds ratio per 1 mm increment0.8; 95% confidence interval, 0.0–0.9).
CONCLUSIONS—Larger ipsilateral A1 diameters and A1/M1 diameter ratio are associated with embolic ACAS. These findings suggest that A1 diameters and M1 diameters are important in determining the path of emboli that reach the terminal internal carotid artery. |
| doi_str_mv | 10.1161/STROKEAHA.114.005672 |
| format | article |
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METHODS—Consecutive patients admitted to Boston Medical Center with embolic ACAS were reviewed. Ipsilateral and contralateral A1 diameters, M1 diameters, and terminal internal carotid artery bifurcation angles were measured from computed tomographic angiography and MRI angiography images. We compared these measurements between cases of ACAS and consecutive cases of embolic middle cerebral artery territory strokes.
RESULTS—The study comprised 55 individuals (27 ACAS, 28 middle cerebral artery territory strokes) with mean age of 69 years. In multivariate regression analysis, larger ipsilateral A1 diameters (odds ratio per 1 mm increment8.5; 95% confidence interval, 1.4–53.3) and ipsilateral A1/M1 diameter ratio (odds ratio per 10% increment1.8; 95% confidence interval, 1.2–2.9) were associated with ACAS, whereas larger ipsilateral M1 diameters was protective for ACAS (odds ratio per 1 mm increment0.8; 95% confidence interval, 0.0–0.9).
CONCLUSIONS—Larger ipsilateral A1 diameters and A1/M1 diameter ratio are associated with embolic ACAS. These findings suggest that A1 diameters and M1 diameters are important in determining the path of emboli that reach the terminal internal carotid artery.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.114.005672</identifier><identifier>PMID: 25082805</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Aged ; Anterior Cerebral Artery - anatomy & histology ; Anterior Cerebral Artery - diagnostic imaging ; Anterior Cerebral Artery - physiopathology ; Biological and medical sciences ; Carotid Artery, Internal - anatomy & histology ; Carotid Artery, Internal - diagnostic imaging ; Carotid Artery, Internal - physiopathology ; Cerebral Angiography ; Cross-Sectional Studies ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Hemodynamics ; Humans ; Infarction, Anterior Cerebral Artery - diagnostic imaging ; Infarction, Anterior Cerebral Artery - physiopathology ; Magnetic Resonance Angiography ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Odds Ratio ; Retrospective Studies ; Thromboembolism ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2014-09, Vol.45 (9), p.2798-2800</ispartof><rights>2014 American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4322-7ee481990757f0df190d24db9e01f0c92d73ad739f9cefa9a87ec34b2e7334b43</citedby><cites>FETCH-LOGICAL-c4322-7ee481990757f0df190d24db9e01f0c92d73ad739f9cefa9a87ec34b2e7334b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27936,27937</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28772449$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25082805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shoamanesh, Ashkan</creatorcontrib><creatorcontrib>Masoud, Hesham</creatorcontrib><creatorcontrib>Furey, Katrina</creatorcontrib><creatorcontrib>Duerfeldt, Kaylyn</creatorcontrib><creatorcontrib>Lau, Helena</creatorcontrib><creatorcontrib>Romero, Jose R</creatorcontrib><creatorcontrib>Pikula, Aleksandra</creatorcontrib><creatorcontrib>Teal, Philip</creatorcontrib><creatorcontrib>Nguyen, Thanh N</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Babikian, Viken L</creatorcontrib><title>Larger A1/M1 Diameter Ratio Predicts Embolic Anterior Cerebral Artery Territorial Stroke</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>BACKGROUND AND PURPOSE—In contrast to middle cerebral artery territory strokes, anterior cerebral artery strokes (ACAS) occur rarely. The low frequency of ACAS, in relation to middle cerebral artery territory strokes, may be explained by differences in ACA and middle cerebral artery anatomy influencing their respective flow-directed embolism rates. We aimed to determine whether variability in ACA anatomy, and in particular A1 segment diameter, is associated with embolic ACAS.
METHODS—Consecutive patients admitted to Boston Medical Center with embolic ACAS were reviewed. Ipsilateral and contralateral A1 diameters, M1 diameters, and terminal internal carotid artery bifurcation angles were measured from computed tomographic angiography and MRI angiography images. We compared these measurements between cases of ACAS and consecutive cases of embolic middle cerebral artery territory strokes.
RESULTS—The study comprised 55 individuals (27 ACAS, 28 middle cerebral artery territory strokes) with mean age of 69 years. In multivariate regression analysis, larger ipsilateral A1 diameters (odds ratio per 1 mm increment8.5; 95% confidence interval, 1.4–53.3) and ipsilateral A1/M1 diameter ratio (odds ratio per 10% increment1.8; 95% confidence interval, 1.2–2.9) were associated with ACAS, whereas larger ipsilateral M1 diameters was protective for ACAS (odds ratio per 1 mm increment0.8; 95% confidence interval, 0.0–0.9).
CONCLUSIONS—Larger ipsilateral A1 diameters and A1/M1 diameter ratio are associated with embolic ACAS. These findings suggest that A1 diameters and M1 diameters are important in determining the path of emboli that reach the terminal internal carotid artery.</description><subject>Aged</subject><subject>Anterior Cerebral Artery - anatomy & histology</subject><subject>Anterior Cerebral Artery - diagnostic imaging</subject><subject>Anterior Cerebral Artery - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Carotid Artery, Internal - anatomy & histology</subject><subject>Carotid Artery, Internal - diagnostic imaging</subject><subject>Carotid Artery, Internal - physiopathology</subject><subject>Cerebral Angiography</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Infarction, Anterior Cerebral Artery - diagnostic imaging</subject><subject>Infarction, Anterior Cerebral Artery - physiopathology</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Odds Ratio</subject><subject>Retrospective Studies</subject><subject>Thromboembolism</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp9kE1v1DAQhi0EokvhHyCUCxKXtOOPrO1jtCwUsaioXSRukeNMqKmzLuOsqv57jHYpNw7W6B0_M7Yexl5zOON8yc-vt1eXn9ftRVuiOgNollo8YQveCFWrpTBP2QJA2looa0_Yi5x_AoCQpnnOTkQDRhhoFuz7xtEPpKrl51949T64CecSr9wcUvWVcAh-ztV66lMMvmp35TIkqlZI2JOLVUul81BtkSjMiUJpXc-UbvEleza6mPHVsZ6ybx_W29VFvbn8-GnVbmqvpBC1RlSGWwu60SMMI7cwCDX0FoGP4K0YtHTl2NF6HJ11RqOXqheoZSlKnrJ3h713lH7tMc_dFLLHGN0O0z53vGk0GKm4LKg6oJ5SzoRjd0dhcvTQcej-OO0enZaouoPTMvbm-MK-n3B4HPorsQBvj4DL3sWR3M6H_I8zWgulbOHMgbtPsVjLt3F_j9TdoIvzzf__8Btf8pDy</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Shoamanesh, Ashkan</creator><creator>Masoud, Hesham</creator><creator>Furey, Katrina</creator><creator>Duerfeldt, Kaylyn</creator><creator>Lau, Helena</creator><creator>Romero, Jose R</creator><creator>Pikula, Aleksandra</creator><creator>Teal, Philip</creator><creator>Nguyen, Thanh N</creator><creator>Kase, Carlos S</creator><creator>Babikian, Viken L</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Larger A1/M1 Diameter Ratio Predicts Embolic Anterior Cerebral Artery Territorial Stroke</title><author>Shoamanesh, Ashkan ; Masoud, Hesham ; Furey, Katrina ; Duerfeldt, Kaylyn ; Lau, Helena ; Romero, Jose R ; Pikula, Aleksandra ; Teal, Philip ; Nguyen, Thanh N ; Kase, Carlos S ; Babikian, Viken L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4322-7ee481990757f0df190d24db9e01f0c92d73ad739f9cefa9a87ec34b2e7334b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Anterior Cerebral Artery - anatomy & histology</topic><topic>Anterior Cerebral Artery - diagnostic imaging</topic><topic>Anterior Cerebral Artery - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Carotid Artery, Internal - anatomy & histology</topic><topic>Carotid Artery, Internal - diagnostic imaging</topic><topic>Carotid Artery, Internal - physiopathology</topic><topic>Cerebral Angiography</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Infarction, Anterior Cerebral Artery - diagnostic imaging</topic><topic>Infarction, Anterior Cerebral Artery - physiopathology</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Odds Ratio</topic><topic>Retrospective Studies</topic><topic>Thromboembolism</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shoamanesh, Ashkan</creatorcontrib><creatorcontrib>Masoud, Hesham</creatorcontrib><creatorcontrib>Furey, Katrina</creatorcontrib><creatorcontrib>Duerfeldt, Kaylyn</creatorcontrib><creatorcontrib>Lau, Helena</creatorcontrib><creatorcontrib>Romero, Jose R</creatorcontrib><creatorcontrib>Pikula, Aleksandra</creatorcontrib><creatorcontrib>Teal, Philip</creatorcontrib><creatorcontrib>Nguyen, Thanh N</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Babikian, Viken L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shoamanesh, Ashkan</au><au>Masoud, Hesham</au><au>Furey, Katrina</au><au>Duerfeldt, Kaylyn</au><au>Lau, Helena</au><au>Romero, Jose R</au><au>Pikula, Aleksandra</au><au>Teal, Philip</au><au>Nguyen, Thanh N</au><au>Kase, Carlos S</au><au>Babikian, Viken L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Larger A1/M1 Diameter Ratio Predicts Embolic Anterior Cerebral Artery Territorial Stroke</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2014-09</date><risdate>2014</risdate><volume>45</volume><issue>9</issue><spage>2798</spage><epage>2800</epage><pages>2798-2800</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>BACKGROUND AND PURPOSE—In contrast to middle cerebral artery territory strokes, anterior cerebral artery strokes (ACAS) occur rarely. The low frequency of ACAS, in relation to middle cerebral artery territory strokes, may be explained by differences in ACA and middle cerebral artery anatomy influencing their respective flow-directed embolism rates. We aimed to determine whether variability in ACA anatomy, and in particular A1 segment diameter, is associated with embolic ACAS.
METHODS—Consecutive patients admitted to Boston Medical Center with embolic ACAS were reviewed. Ipsilateral and contralateral A1 diameters, M1 diameters, and terminal internal carotid artery bifurcation angles were measured from computed tomographic angiography and MRI angiography images. We compared these measurements between cases of ACAS and consecutive cases of embolic middle cerebral artery territory strokes.
RESULTS—The study comprised 55 individuals (27 ACAS, 28 middle cerebral artery territory strokes) with mean age of 69 years. In multivariate regression analysis, larger ipsilateral A1 diameters (odds ratio per 1 mm increment8.5; 95% confidence interval, 1.4–53.3) and ipsilateral A1/M1 diameter ratio (odds ratio per 10% increment1.8; 95% confidence interval, 1.2–2.9) were associated with ACAS, whereas larger ipsilateral M1 diameters was protective for ACAS (odds ratio per 1 mm increment0.8; 95% confidence interval, 0.0–0.9).
CONCLUSIONS—Larger ipsilateral A1 diameters and A1/M1 diameter ratio are associated with embolic ACAS. These findings suggest that A1 diameters and M1 diameters are important in determining the path of emboli that reach the terminal internal carotid artery.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>25082805</pmid><doi>10.1161/STROKEAHA.114.005672</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anterior Cerebral Artery - anatomy & histology Anterior Cerebral Artery - diagnostic imaging Anterior Cerebral Artery - physiopathology Biological and medical sciences Carotid Artery, Internal - anatomy & histology Carotid Artery, Internal - diagnostic imaging Carotid Artery, Internal - physiopathology Cerebral Angiography Cross-Sectional Studies Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Hemodynamics Humans Infarction, Anterior Cerebral Artery - diagnostic imaging Infarction, Anterior Cerebral Artery - physiopathology Magnetic Resonance Angiography Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Odds Ratio Retrospective Studies Thromboembolism Vascular diseases and vascular malformations of the nervous system |
| title | Larger A1/M1 Diameter Ratio Predicts Embolic Anterior Cerebral Artery Territorial Stroke |
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