Prevalence and Outcomes of Symptomatic Intracranial Large Artery Stenoses and Occlusions in China

Prevalence and Outcomes of Symptomatic Intracranial Large Artery Stenoses and Occlusions in China · SciRah

^aFrom Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^bDepartment of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR (Y.O.Y.S., X.Z., T.W.H.L., K.S.L.W.)
^cGuangdong Hospital of Traditional Chinese Medicine, Guangzhou, China (Y.C.)
^dShanghai Pudong New Area People’s Hospital, Shanghai, China (Q.B.)
^eHandan First People’s Hospital, Shanghai, China (Yi. Wu)
^fGuangzhou
^gGuangzhou City People's First Hospital, Guangzhou, China (X.P.)
^hHandan First People's Hospital, Shanghai, China (Yi. Wu)
ⁱShanghai Pudong New Area People's Hospital, Shanghai, China (Q.B.)
^jThe First Affiliated Hospital of Zhejiang University, Zhejiang, China (B.L.)
^kYongjun Wang From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^lXingquan Zhao From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^mLiping Liu From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
ⁿYannie O.Y. Soo From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^oYuehua Pu From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^pYuesong Pan From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^qYilong Wang From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^rXinying Zou From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^sThomas W.H. Leung From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^tYefeng Cai From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^uQingke Bai From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^vYiping Wu From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^wChunxue Wang From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^xXiaoping Pan From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^yBenyan Luo From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^zKa Sing Lawrence Wong From Beijing Tiantan Hospital of Capital Medical University, Beijing, China (Yo. Wang, X.Z., L.L., Y. Pu, Y. Pan, Yi. Wang, C.W.)
^aaBeijing Tongren Hospital of Capital Medical University, Beijing
^abXiaojun Zhang
^acShanghai Sixth People’s Hospital, Shanghai
^adXiaojiang Sun
^aeLan Yu
^afTianjin Huanhu Hosptial, Tianjin
^agMinxia Guo
^ahShanxi Provincial People’s Hospital, Xi’an, Shanxi
^aiQilin Ma
^ajThe First Affiliated Hospital of Xiamen University, Xiamen, Fujian
^akBo Xiao
^alLe Zhang
^amXiangya Hospital Central South University, Changsha, Hunan
^anNo. 3 People’s Hospital of Chengdu, Chengdu, Sichuan
^aoZhong Zhang
^apAnding Xu
^aqThe First Affiliated Hospital of Jinan University (Guangzhou Overseas Hospital), Guangzhou, Guangdong
^arHandan Central Hospital, Handan, Heibei
^asJuntao Li
^atHandan First People’s Hospital, Handan, Heibei
^auJie Lin
^avChengming Xing
^awQingdao Municipal Hospital, Qingdao, Shandong
^axThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan
^ayYuming Xu
^azRongyuan Zheng

Abstract

BACKGROUND AND PURPOSE: We aimed to establish the prevalence, characteristics, and outcomes of intracranial atherosclerosis (ICAS) in China by a large, prospective, multicenter study. METHODS: We evaluated 2864 consecutive patients who experienced an acute cerebral ischemia<7 days after symptom onset in 22 Chinese hospitals. All patients underwent magnetic resonance angiography, with measurement of diameter of the main intracranial arteries. ICAS was defined as ≥50% diameter reduction on magnetic resonance angiography. RESULTS: The prevalence of ICAS was 46.6% (1335 patients, including 261 patients with coexisting extracranial carotid stenosis). Patients with ICAS had more severe stroke at admission and stayed longer in hospitals compared with those without intracranial stenosis (median National Institutes of Health Stroke Scale score, 3 versus 5; median length of stay, 14 versus 16 days; both P<0.0001). After 12 months, recurrent stroke occurred in 3.27% of patients with no stenosis, in 3.82% for those with 50% to 69% stenosis, in 5.16% for those with 70% to 99% stenosis, and in 7.27% for those with total occlusion. Cox proportional hazards regression analyses showed that the degree of arterial stenosis, age, family history of stroke, history of cerebral ischemia or heart disease, complete circle of Willis, and National Institutes of Health Stroke Scale score at admission were independent predictors for recurrent stroke at 1 year. The highest rate of recurrence was observed in patients with occlusion with the presence of ≥3 additional risk factors. CONCLUSIONS: ICAS is the most common vascular lesion in patients with cerebrovascular disease in China. Recurrent stroke rate in our study was lower compared with those of previous clinical trials but remains unacceptably high in a subgroup of patients with severe stenosis.

TL;DRRecurrent stroke rate in this study was lower compared with those of previous clinical trials but remains unacceptably high in a subgroup of patients with severe stenosis. (Semantic Scholar)

Prevalence and Outcomes of Symptomatic Intracranial Large Artery Stenoses and Occlusions in China

Abstract

Plain-language summary

Discussion