Endovascular Therapy of Cerebral Arterial Occlusions: Intracranial Atherosclerosis versus Embolism

Background Treatment strategy for acute arterial occlusions due to intracranial atherosclerotic disease (IAD) may differ from those due to embolism (embolic). The aims were to differentiate and classify angiographically defined occlusion due to IAD versus embolism and identify baseline clinical fact...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2015-09, Vol.24 (9), p.2074-2080
Main Authors: Lee, Jin Soo, MD, PhD, Hong, Ji Man, MD, PhD, Lee, Kyu Sun, MD, Suh, Hong Il, MD, Demchuk, Andrew M., MD, FRCPC, Hwang, Yang-Ha, MD, PhD, Kim, Byung Moon, MD, PhD, Kim, Jong S., MD, PhD
Format: Article
Language:English
Subjects:
acute ischemic stroke
Aged
Aged, 80 and over
Cardiovascular
Cerebral Angiography
cerebrovascular disorders
Cholesterol - blood
Embolism - surgery
Endovascular Procedures - methods
Female
Fibrinolytic Agents
Humans
Intracranial Arteriosclerosis - surgery
Intracranial atherosclerosis
intracranial embolism
Male
Middle Aged
Neurology
Regression Analysis
Risk Factors
thrombectomy
thrombolytic therapy
Tissue Plasminogen Activator - administration & dosage
Treatment Outcome
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Summary:Background Treatment strategy for acute arterial occlusions due to intracranial atherosclerotic disease (IAD) may differ from those due to embolism (embolic). The aims were to differentiate and classify angiographically defined occlusion due to IAD versus embolism and identify baseline clinical factors associated with IAD-related occlusion. Methods Acute ischemic stroke patients with large cerebral artery occlusions on computed tomography angiography who underwent transfemoral cerebral angiography for endovascular treatment were included. Patients were categorized as the embolic (no evidence of focal stenosis after recanalization) or IAD group (significant fixed focal stenosis in the occlusion site, evidenced in the final angiography or during the endovascular treatment procedure) based on transfemoral cerebral angiography findings. Results In total, 158 patients were included. The IAD group patients (n = 24) were younger ( P  = .005), more often male ( P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2015.05.003