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Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis

Year 2024, Volume: 77 Issue: 3, 243 - 247, 10.10.2024

Abstract

Objectives: The origin of the extracranial vertebral artery (V1 segment) is a common site for large artery atherosclerosis (LAA). The aim of this study was to determine the risk factors, prevalence and prognosis of the patients presented with acute ischemic stroke due to vertebrobasilar atherosclerosis and additional V1 stenosis. Materials and Methods: We reviewed the charts of 957 patients who were admitted with acute ischemic stroke between the dates January 2011 and May 2017, and selected cases with stroke related to posterior circulation (PC) atherosclerosis. The demographic data, risk factors, National Institutes of Health Stroke Scale (NIHSS) scores at admission, and modified Rankin scores (mRS) in the follow-up period were recorded.

Results: There were 80 (8.36%) patients with acute ischemic stroke in the PC due to LAA. Thirty (37.5%) patients [9 females (30%), mean age 67.4±14.3 years] had V1 stenosis. No between group differences in the history of vascular risk factors and mRS scores during the follow-up period were observed (p>0.05). In logistic regression analysis, the admission NIHSS score was higher in patients with V1 stenosis than others (p=0.022).
Conclusion: In our registry, more than one third of patients with acute PC stroke due to LAA had stenosis in the origin of the vertebral artery. The patients with coexisting V1 stenosis presented with relatively severe stroke.

Ethical Statement

The Ankara University Faculty of Medicine Clinical Research Ethics Committee granted ethical approval for this study (date: 27.05.2019, approval no.: 10-772- 19).

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References

  • 1. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke. 1988;19:1083-1092.
  • 2. Yamamoto Y, Georgiadis AL, Chang HM, et al. Posterior cerebral artery territory infarcts in the New England Medical Center Posterior Circulation Registry. Arch Neurol. 1999;56:824-832.
  • 3. Caplan L. Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000. Stroke. 2000;31:2011-2023.
  • 4. Mazighi M, Labreuche J, Gongora-Rivera F, et al. Autopsy prevalence of proximal extracranial atherosclerosis in patients with fatal stroke. Stroke. 2009;40:713-718.
  • 5. Ay H, Furie KL, Singhal A, et al. An evidence-based causative classification system for acute ischemic stroke. Ann Neurol. 2005;58:688-697.
  • 6. Petty GW, Brown RD Jr, Whisnant JP, et al. Ischemic stroke subtypes: a population-based study of incidence and risk factors. Stroke. 1999;30:2513- 2516.
  • 7. Markus HS, van der Worp HB, Rothwell PM. Posterior circulation ischaemic stroke and transient ischaemic attack: diagnosis, investigation, and secondary prevention. Lancet Neurol. 2013;12:989-998.
  • 8. Caplan L, Chung CS, Wityk R, et al. New England medical center posterior circulation stroke registry: I. Methods, data base, distribution of brain lesions, stroke mechanisms, and outcomes. J Clin Neurol. 2005;1:14-30.
  • 9. Grau AJ, Weimar C, Buggle F, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German Stroke Data Bank. Stroke. 2001;32:2559-2566.
  • 10. Borhani-Haghighi A, Emami M, Vasaksi AS, et al. Large-vessel stenosis in the patients with ischemic stroke in Iran: Prevalence, pattern, and risk factors. J Vasc Interv Neurol. 2015;8:11-16.
  • 11. Rothwell PM, Coull AJ, Giles MF, et al. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet. 2004;363:1925-1933.
  • 12. Rodríguez-Ortiz ME, Gómez-Delgado F, Arenas de Larriva AP, et al. Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study). Sci Rep. 2019;9:8013.
  • 13. Paffen E, DeMaat MP. C-reactive protein in atherosclerosis: A causal factor? Cardiovasc Res. 2006;71:30-39.
  • 14. den Hertog HM, van Rossum JA, van der Worp HB, et al. C-reactive protein in the very early phase of acute ischemic stroke: association with poor outcome and death. J Neurol. 2009;256:2003-2008.
  • 15. Finck T, Sperl P, Hernandez-Petzsche M, et al. Inflammation in stroke: initial CRP levels can predict poor outcomes in endovascularly treated stroke patients. Front Neurol. 2023;14:1167549.
  • 16. Xu Q, Hu L, Chen L, et al. Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients. CNS Neurosci Ther. 2023;29:842-854

Büyük Arter Aterosklerozuna Bağlı Posterior Dolaşımda İnmesi Olan Hastalarda Vertebral Arter Orjin Stenozları

Year 2024, Volume: 77 Issue: 3, 243 - 247, 10.10.2024

Abstract

Project Number

-

References

  • 1. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke. 1988;19:1083-1092.
  • 2. Yamamoto Y, Georgiadis AL, Chang HM, et al. Posterior cerebral artery territory infarcts in the New England Medical Center Posterior Circulation Registry. Arch Neurol. 1999;56:824-832.
  • 3. Caplan L. Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000. Stroke. 2000;31:2011-2023.
  • 4. Mazighi M, Labreuche J, Gongora-Rivera F, et al. Autopsy prevalence of proximal extracranial atherosclerosis in patients with fatal stroke. Stroke. 2009;40:713-718.
  • 5. Ay H, Furie KL, Singhal A, et al. An evidence-based causative classification system for acute ischemic stroke. Ann Neurol. 2005;58:688-697.
  • 6. Petty GW, Brown RD Jr, Whisnant JP, et al. Ischemic stroke subtypes: a population-based study of incidence and risk factors. Stroke. 1999;30:2513- 2516.
  • 7. Markus HS, van der Worp HB, Rothwell PM. Posterior circulation ischaemic stroke and transient ischaemic attack: diagnosis, investigation, and secondary prevention. Lancet Neurol. 2013;12:989-998.
  • 8. Caplan L, Chung CS, Wityk R, et al. New England medical center posterior circulation stroke registry: I. Methods, data base, distribution of brain lesions, stroke mechanisms, and outcomes. J Clin Neurol. 2005;1:14-30.
  • 9. Grau AJ, Weimar C, Buggle F, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German Stroke Data Bank. Stroke. 2001;32:2559-2566.
  • 10. Borhani-Haghighi A, Emami M, Vasaksi AS, et al. Large-vessel stenosis in the patients with ischemic stroke in Iran: Prevalence, pattern, and risk factors. J Vasc Interv Neurol. 2015;8:11-16.
  • 11. Rothwell PM, Coull AJ, Giles MF, et al. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet. 2004;363:1925-1933.
  • 12. Rodríguez-Ortiz ME, Gómez-Delgado F, Arenas de Larriva AP, et al. Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study). Sci Rep. 2019;9:8013.
  • 13. Paffen E, DeMaat MP. C-reactive protein in atherosclerosis: A causal factor? Cardiovasc Res. 2006;71:30-39.
  • 14. den Hertog HM, van Rossum JA, van der Worp HB, et al. C-reactive protein in the very early phase of acute ischemic stroke: association with poor outcome and death. J Neurol. 2009;256:2003-2008.
  • 15. Finck T, Sperl P, Hernandez-Petzsche M, et al. Inflammation in stroke: initial CRP levels can predict poor outcomes in endovascularly treated stroke patients. Front Neurol. 2023;14:1167549.
  • 16. Xu Q, Hu L, Chen L, et al. Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients. CNS Neurosci Ther. 2023;29:842-854
There are 16 citations in total.

Details

Primary Language English
Subjects Neurology and Neuromuscular Diseases
Journal Section Research Article
Authors

Seyda Erdoğan 0000-0003-2759-9562

Turgut Şahin This is me 0000-0002-5757-2590

Mine Hayriye Sorgun 0000-0003-2370-7319

Fatma Tuğra Karaaslan This is me 0000-0001-7210-4923

Zerin Özaydın Aksun 0000-0003-1154-4276

Ömer Eray Yalap This is me 0000-0001-9900-0745

Onur Bulut 0000-0003-4995-7025

Büşra Ölmez

Abdullah Yasir Yılmaz This is me 0000-0001-7143-164X

Zehra Yavuz 0000-0002-3627-5212

Canan Önder 0000-0002-6964-0896

Aygül Nadirova This is me 0009-0006-5759-3371

Mustafa Erdoğan 0000-0003-0109-2296

Eda Aslanbaba This is me

Tehran Allahverdiyev

Canan Togay Işıkay This is me 0000-0001-6256-9487

Project Number -
Publication Date October 10, 2024
Submission Date May 29, 2024
Acceptance Date July 8, 2024
Published in Issue Year 2024 Volume: 77 Issue: 3

Cite

APA Erdoğan, S., Şahin, T., Sorgun, M. H., … Karaaslan, F. T. (2024). Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 77(3), 243-247. https://doi.org/10.4274/atfm.galenos.2024.59013
AMA Erdoğan S, Şahin T, Sorgun MH, et al. Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 2024;77(3):243-247. doi:10.4274/atfm.galenos.2024.59013
Chicago Erdoğan, Seyda, Turgut Şahin, Mine Hayriye Sorgun, Fatma Tuğra Karaaslan, Zerin Özaydın Aksun, Ömer Eray Yalap, Onur Bulut, et al. “Vertebral Artery Origin Stenosis in Patients With Posterior Circulation Strokes Due to Large Artery Atherosclerosis”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77, no. 3 (October 2024): 243-47. https://doi.org/10.4274/atfm.galenos.2024.59013.
EndNote Erdoğan S, Şahin T, Sorgun MH, Karaaslan FT, Özaydın Aksun Z, Yalap ÖE, Bulut O, Ölmez B, Yılmaz AY, Yavuz Z, Önder C, Nadirova A, Erdoğan M, Aslanbaba E, Allahverdiyev T, Togay Işıkay C (October 1, 2024) Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77 3 243–247.
IEEE S. Erdoğan et al., “Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 3, pp. 243–247, 2024, doi: 10.4274/atfm.galenos.2024.59013.
ISNAD Erdoğan, Seyda et al. “Vertebral Artery Origin Stenosis in Patients With Posterior Circulation Strokes Due to Large Artery Atherosclerosis”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77/3 (October2024), 243-247. https://doi.org/10.4274/atfm.galenos.2024.59013.
JAMA Erdoğan S, Şahin T, Sorgun MH, Karaaslan FT, Özaydın Aksun Z, Yalap ÖE, Bulut O, Ölmez B, Yılmaz AY, Yavuz Z, Önder C, Nadirova A, Erdoğan M, Aslanbaba E, Allahverdiyev T, Togay Işıkay C. Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77:243–247.
MLA Erdoğan, Seyda et al. “Vertebral Artery Origin Stenosis in Patients With Posterior Circulation Strokes Due to Large Artery Atherosclerosis”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 3, 2024, pp. 243-7, doi:10.4274/atfm.galenos.2024.59013.
Vancouver Erdoğan S, Şahin T, Sorgun MH, Karaaslan FT, Özaydın Aksun Z, Yalap ÖE, et al. Vertebral Artery Origin Stenosis in Patients with Posterior Circulation Strokes Due to Large Artery Atherosclerosis. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77(3):243-7.