Abstract TP244: Angiographic Findings Associated With Ischemic and Hemorrhagic Stroke in Intracranial Artery Dissection

Abstract

Background and Purpose: Intracranial artery dissection (IAD) can cause subsequent ischemic stroke, hemorrhagic stroke or both. Although radiological findings of IAD widely include aneurysmal dilatation, segmental stenosis, or occlusion, it is unclear to what extent of each finding related to incident stroke. We tested whether findings by digital subtraction angiography (DSA) assessments were associated with increased risks of ischemic and hemorrhagic stroke in patients with IAD Methods: We retrieved data on consecutive patients with IAD within one month from onset who underwent DSA from single-center prospective cohort databases from February 2011 to November 2016. DSA was used to determine fusiform or irregular aneurysmal dilation, intimal flap or double lumen, and pearl-and-string sign according to proposed imaging diagnostic criteria. We assessed clinical and radiographic variables associated with IAD and subsequent stroke subtypes using logistic regression analyses. Result: Of the total 105 patients with IAD (mean age, 52±2 years; 30% men), 92 patients had DSA assessments. Among them, 36 patients had acute ischemic stroke (AIS) or transient ischemic attack (TIA) and 40 patients had subarachnoid hemorrhage (SAH). In multivariate analysis, current smoking (odds ratio [OR], 2.78; 95% confidence interval (CI), 1.00-8.00) and string sign (stenosis) (OR 3.24, 95% CI, 1.04-10.81) were associated with AIS/TIA, whereas intimal flap (OR, 15.44; 95% CI, 5.05-55.73) and irregular aneurysm dilatation (OR, 24.94; 95% CI, 7.34-119.04) were associated with SAH. Conclusion: Patients who developed AIS/TIA were related to current smoking and string sign, and patients who developed SAH were related to intimal flap and fusiform or irregular aneurysmal dilatation.