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Intracranial Atherosclerotic Plaque as a Potential Cause of Embolic Stroke of Undetermined Source.
Tao, Lin; Li, Xiao-Qiu; Hou, Xiao-Wen; Yang, Ben-Qiang; Xia, Cheng; Ntaios, George; Chen, Hui-Sheng.
Afiliação
  • Tao L; Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China.
  • Li XQ; Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China.
  • Hou XW; Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China.
  • Yang BQ; Department of Radiology, General Hospital of Northern Theater Command, Shen Yang, China.
  • Xia C; Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China.
  • Ntaios G; Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
  • Chen HS; Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China. Electronic address: chszh@aliyun.com.
J Am Coll Cardiol ; 77(6): 680-691, 2021 02 16.
Article em En | MEDLINE | ID: mdl-33573737
BACKGROUND: Previous studies investigated the potential mechanism of embolic stroke of undetermined source (ESUS) from extracranial artery plaque, but there has been no study other than a case report on high-risk intracranial plaque in ESUS. OBJECTIVES: The aim of this study was to investigate the issue by evaluating the morphology and composition of intracranial plaque in patients with ESUS and small-vessel disease (SVD) using 3.0-T high-resolution magnetic resonance imaging. METHODS: Two hundred forty-three consecutive patients with ESUS and 160 patients with SVD-associated stroke between January 2015 and December 2019 were retrospectively enrolled. Multidimensional parameters involving the presence of plaque on both sides, including remodeling index (RI), plaque burden, presence of discontinuity of plaque surface, thick fibrous cap, intraplaque hemorrhage, and complicated American Heart Association type VI plaque at the maximal luminal narrowing site, were evaluated using intracranial high-resolution magnetic resonance imaging. RESULTS: Among 243 patients with ESUS, the prevalence of intracranial plaque was much higher in the ipsilateral than the contralateral side (63.8% vs. 42.8%; odds ratio [OR]: 5.25; 95% confidence interval [CI]: 2.83 to 9.73), a finding that was not evident in patients with SVD (35.6% vs. 30.6%; OR: 2.14; 95% CI: 0.87 to 5.26; p = 0.134). Logistic analysis showed that RI was independently associated with ESUS in model 1 (OR: 2.329; 95% CI: 1.686 to 3.217; p < 0.001) and model 2 (OR: 2.295; 95% CI: 1.661 to 3.172; p < 0.001). RI alone with an optimal cutoff of 1.162, corresponding to an area under the curve of 0.740, had good diagnostic efficiency for ESUS. CONCLUSIONS: The present study supports an etiologic role of high-risk nonstenotic intracranial plaque in ESUS.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Arteriosclerose Intracraniana / Acidente Vascular Cerebral / Embolia Intracraniana / Placa Aterosclerótica Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Arteriosclerose Intracraniana / Acidente Vascular Cerebral / Embolia Intracraniana / Placa Aterosclerótica Idioma: En Ano de publicação: 2021 Tipo de documento: Article