Vulnerable Intracranial Atherosclerotic Plaques: A Morphology Study By 3-Dimensional Rotational Angiography
Refereed conference paper presented and published in conference proceedings

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摘要Background and Aims: Intracranial atherosclerotic disease (ICAD) is a major ischemic stroke subtype. Understanding the morphology of acute symptomatic plaques may identify vulnerable lesions and guide treatment.

Method:We performed 3-dimensional rotational angiography (3DRA) in 173 patients (median age¼60 years) within 4 weeks from an acute ischemic stroke or transient ischemic attack attributed to high-grade ICAD (>60% stenosis).We reviewed the infarct topography in DWI and FLAIR/ T2 MRI brain over the corresponding vascular territory, and investigated if plaque morphology might differ in patients with or without DWI/ FLAIR/T2 lesions.

Results: Among the 173 culprit lesions distributing in middle cerebral artery (MCA)-M1 (n¼127); intracranial internal carotid artery (ICA)- C6/7 (n¼26); across both MCA and ICA (n¼5); basilar artery (n¼13); and vertebral artery-V4 (n¼2), the median luminal stenosis over the thickest plaque region was 75%. In terms of surface lining, the plaques were smooth, irregular, or ulcerative in 51 (29.5%), 95 (54.9%), and 27 (15.6%). Ulcerative plaques were thicker (p¼0.002), more eccentric (p¼0.043), of a steeper upstream shoulder (p<0.001), and were significantly associated with adjacent branch atheromatous disease (p¼0.026) compared with smooth or irregular plaques. Patients harboring ulcerative plaques had more concurrent acute and chronic infarcts in the corresponding watershed regions than those with smooth plaques (odds ratio=5.82; p¼0.006).

Conclusion: Ulcerative plaques in cerebral arteries were associated with a higher plaque burden and vulnerable geometric features. The presence of more old-and-new infarcts with ulcerated plaques might represent
recurrent artery-to-artery thrombo-embolism.
出版社接受日期16.05.2018
著者T.W. Leung, C. Leng, Y. Soo, B. Ip, A. Lau, V. Mok, A. Wong, J. Abrigo, S. Yu
會議名稱4th European Stroke Organisation Conference
會議開始日16.05.2018
會議完結日18.05.2018
會議地點Gothenburg
會議國家/地區瑞典
會議論文集題名European Stroke Journal
系列標題Scientific Communications - Pathophysiology and Mechanisms
叢書冊次AS17-008
出版年份2018
月份5
卷號3
期次Suppl 1
出版社SAGE PUBLICATIONS LTD
頁次73 - 73
語言英式英語

上次更新時間 2020-16-11 於 00:56