Abstract WP169: Symptomatic Intracranial Atherosclerotic Stenosis: The Associations Between Cerebral Hemodynamics and the Stroke Mechanisms

医学 栓塞 心脏病学 冲程(发动机) 狭窄 内科学 血流动力学 病变 灌注 放射科 血管造影 外科 机械工程 工程类
作者
Xueyan Feng,Ka Lung Chan,Jill Abrigo,Linda Yu-Ling Lan,Yuming Xu,Hui Fang,Yannie Soo,Thomas Leung,Xinyi Leng
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:51 (Suppl_1) 被引量:1
标识
DOI:10.1161/str.51.suppl_1.wp169
摘要

Background: Intracranial atherosclerotic stenosis (ICAS) may cause ischemic stroke by various mechanisms; artery-to-artery (AA) embolism and hypoperfusion often co-exist and bear a high risk of recurrent stroke despite optimal medical treatment. Little is known regarding how ICAS lesions cause ischemic strokes via different mechanisms, while the hemodynamic features of ICAS lesions may play an important role. Methods: Patients with acute ischemic stroke attributed to 50-99% ICAS in the anterior circulation confirmed in CT angiography (CTA) were recruited from two teaching hospitals. We classified probable stroke mechanisms as parent artery atherosclerosis occluding penetrating artery (PAO), AA embolism, hypoperfusion, and mixed mechanisms, based on infarct topography and ICAS lesion features. Computational fluid dynamics (CFD) models were built based on CTA to simulate blood flow across culprit ICAS lesions. We calculated translesional pressure ratio (PR), the ratio of pressures distal and proximal to the lesion; and translesional wall shear stress ratio (WSSR), the ratio of WSS at the stenosis throat and at proximal normal vessel segment. We defined PR ≤ median as low PR, indicating larger pressure gradient across the lesion, hence restricted downstream perfusion; and WSSR ≥ 4 th quartile as high WSSR, indicating higher WSS upon the lesion. We associated PR and WSSR with probable stroke mechanisms. Results: Among 99 patients, 44 had AA embolism as a probable stroke mechanism, 13 with AA embolism alone and 31 with coexisting hypoperfusion; 18 and 37 respectively had isolated PAO and isolated hypoperfusion as the probable stroke mechanisms. High WSSR was independently associated with AA embolism (adjusted OR 4.86; p = 0.008). The significant, positive relationship between high WSSR and higher risk of AA embolism remained in those with a low PR (adjusted OR 4.01; p = 0.044), but not in those with a normal PR (p = 0.621). Conclusions: High WSS upon ICAS lesions may increase plaque vulnerability, but it may only cause distal arterial embolism when there is impaired cerebral perfusion. Therefore, in secondary prevention of ischemic stroke in ICAS via AA embolism, impaired cerebral perfusion may be an important therapeutic target.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
sci完成签到 ,获得积分10
1秒前
gougou完成签到,获得积分10
2秒前
羊二呆完成签到,获得积分10
5秒前
球球发布了新的文献求助10
6秒前
椿人完成签到 ,获得积分10
7秒前
Cry_Man完成签到 ,获得积分10
9秒前
路明非完成签到,获得积分10
11秒前
11秒前
wddx完成签到,获得积分10
12秒前
LFY完成签到 ,获得积分10
12秒前
研友_VZG7GZ应助以筱采纳,获得10
12秒前
jwx完成签到,获得积分0
13秒前
小亮哈哈完成签到,获得积分0
15秒前
529完成签到 ,获得积分10
15秒前
15秒前
罗实完成签到 ,获得积分10
18秒前
19秒前
舟遥遥完成签到,获得积分10
23秒前
ahui完成签到 ,获得积分10
24秒前
Present完成签到,获得积分10
24秒前
chuzihang完成签到 ,获得积分10
25秒前
25秒前
夜雨诗意完成签到,获得积分10
27秒前
往返完成签到,获得积分10
28秒前
小唐完成签到,获得积分10
29秒前
章鱼完成签到,获得积分10
32秒前
松松包完成签到,获得积分10
32秒前
34秒前
星辰大海应助王珺采纳,获得10
34秒前
marc107完成签到,获得积分10
34秒前
阜睿完成签到 ,获得积分10
35秒前
乐乐乐乐乐乐完成签到,获得积分10
38秒前
39秒前
39秒前
欧欧欧导完成签到,获得积分10
41秒前
烟花应助wang采纳,获得10
42秒前
43秒前
潇洒的天与完成签到,获得积分10
44秒前
hannah完成签到,获得积分10
45秒前
ajing完成签到,获得积分10
46秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968578
求助须知:如何正确求助?哪些是违规求助? 3513400
关于积分的说明 11167585
捐赠科研通 3248853
什么是DOI,文献DOI怎么找? 1794499
邀请新用户注册赠送积分活动 875131
科研通“疑难数据库(出版商)”最低求助积分说明 804664