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Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians: A Prospective, Multicenter, Transcranial Doppler Study
Author(s) -
Tsivgoulis Georgios,
Vadikolias Konstantinos,
Heliopoulos Ioannis,
Katsibari Chaido,
Voumvourakis Konstantinos,
Tsakaldimi Soultana,
Boutati Eleni,
Vasdekis Spyros N.,
Athanasiadis Dimitrios,
AlAttas Omar S.,
Charalampidis Paris,
Stamboulis Elefterios,
Piperidou Charitomeni
Publication year - 2012
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2012.00707.x
Subject(s) - medicine , transcranial doppler , diabetes mellitus , prospective cohort study , angiography , stroke (engine) , stenosis , magnetic resonance angiography , confounding , radiology , magnetic resonance imaging , infarction , cardiology , myocardial infarction , mechanical engineering , engineering , endocrinology
BACKGROUND There are limited data available regarding symptomatic intracranial atherosclerosis (SIA) prevalence in Caucasians. We sought to investigate SIA prevalence among Caucasian patients hospitalized with acute cerebral ischemia (ACI) in a prospective, multicenter Transcranial Doppler sonography (TCD) study. METHODS Consecutive patients with ACI were prospectively evaluated with TCD over a 24‐month‐period. The previously validated criteria of SONIA trial were used for detection of >50% intracranial stenosis with TCD. Brain angiography was performed to confirm the diagnosis in cases with abnormal TCD findings. SIA was diagnosed when there was evidence of a cerebral infarction in the territory of the stenotic artery (identified by TCD and confirmed by Magnetic resonance angiography [MRA]/Computed tomography angiography [CTA]). RESULTS A total of 467 consecutive patients with ACI (60.4% men, mean age 58 ± 14 years) were evaluated. SIA was documented in 43 patients (9.2%; 95%CI: 6.9%‐12.2%). The most common SIA location was M1MCA (34.9%) followed by TICA (18.8%). Diabetes mellitus (OR: 4.25, 95%CI: 2.18‐8.26; P < .001) and hypertension (OR: 2.41, 95%CI: 1.02‐5.67; P = .045) were independently associated with SIA on multivariate models adjusting for potential confounders. CONCLUSIONS SIA was identified in almost 10% of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI.