Abstract TMP117: Intracranial Dolichoectasia in Patients with Lacunar Strokes: The SPS3 Trial

Abstract

Background and Purpose: Intracranial arterial dolichoectasia (IADE) is a common finding in atherothrombotic strokes, but its relationship with lacunar infarcts is less certain. We investigated the prevalence of IADE and its correlation with risk factors as well as with recurrent stroke within the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. Methods: The greatest diameter of the following arteries was measured on MRA: bilateral internal carotid artery (ICA), middle cerebral artery (MCA), vertebral artery (VA), and the basilar artery (BA). IADE criteria were a diameter of over 7.0 mm for ICA, over 4.0 mm for MCA, over 4.0 mm for VA, and over 4.5 mm for BA. BA elongation was assessed according to Smoker’s criteria. Results: Of the 3020 SPS3 participants, 2562 MRAs were assessed. Diameters were: ICA, 4.4 +/- 0.6 mm; MCA, 2.6 +/- 0.4 mm; BA, 3.4 +/- 0.7 mm; and VA, 2.4 +/- 0.7 mm. Of the measured participants 8% met criteria for IADE; 65% had IADE in a single artery, 28% in two arteries, and 7% in more than two arteries. Abnormality in either height of the bifurcation (66.7% vs. 4.6%, p<0.001) or lateral displacement (45.6% vs. 1.4%, p<0.001) of the BA was observed more frequently in patients with IADE than without. Conclusion: In this large and well characterized cohort of lacunar stroke patients, IADE was present in 8%, approximately half of whom demonstrated BA elongation. The relationship between IADE and incidence of recurrent stroke will be presented. Ongoing analyses from SPS3 will likely elucidate if IADE is a risk factor for stroke recurrence in lacunar stroke patients.