Abstract
BackgroundLarge intracranial occlusive vascular disease is a major contributor to the incidence of stroke worldwide, especially when it involves the middle cerebral artery (MCA). The data on the prognosis of symptomatic atherosclerotic MCA occlusions (MCAO) with concomitant intracranial arterial disease (MCAO-AIS) are limited. MCAO-AIS may reflect the extent of the atherosclerotic intracranial disease, we hypotheses that coexisting intracranial arterial disease influenced the prognosis of MCAO.MethodsPatients having survived at least one month after the initial ischemic stroke who suffered from atherosclerotic occlusion of the MCA were enrolled. According to their concomitant atherosclerotic intracranial arterial disease, the patients were assigned to one of two groups: the MCAO or the MCAO-AIS. All of the patients’ cerebrovascular risk factors were recorded. Recurrent ischemic stroke and death were the end-point events during the follow-up.ResultsA total of 232 patients (mean age 57.68 ± 9.50 years; 69% male) were analyzed. The mean follow-up time was 17.65 months. The end-point events occurred in 35 (15.09%) patients, resulting in an annual rate of 10.26%. The presence of MCAO- AIS was an independent risk factor associated with the patient’s prognosis in the cohort (OR = 3.426, 95% CI 1.261 to 9.308; p = 0.016), as well as gender and diabetes mellitus. The MCAO-AIS were more likely to experience ipsilateral ischemic strokes, but the difference was not statistically significant.ConclusionConcomitant intracranial arterial disease may influence the prognosis of patients with atherosclerotic MCAO. The result warrants further research in larger sample population.
Highlights
Large intracranial occlusive vascular disease is a major contributor to the incidence of stroke worldwide, especially when it involves the middle cerebral artery (MCA)
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In conclusion, we demonstrated that the prevalence of concomitant arterial disease (AIS) in our cohort of subjects with symptomatic MCAO was high and that the MCAO-AIS was an independent prognosis factor
Summary
Large intracranial occlusive vascular disease is a major contributor to the incidence of stroke worldwide, especially when it involves the middle cerebral artery (MCA). The data on the prognosis of symptomatic atherosclerotic MCA occlusions (MCAO) with concomitant intracranial arterial disease (MCAO-AIS) are limited. Previous studies have reported that the annual risk of stroke in patients with symptomatic MCA stenosis is 4% ~ 15% [4,5,6,7]. The prognosis of patients with symptomatic and asymptomatic MCA stenosis has been studied previously, few studies have reported data on patients with a middle cerebral artery occlusion (MCAO). The Previous studies have reported that diabetes mellitus, stroke symptoms, and gender may influence the prognosis of patients with symptomatic MCAO [7,9,10].
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