Document Detail


Angiographic pattern of symptomatic severe M1 stenosis: comparison with presenting symptoms, infarct patterns, perfusion status, and outcome after recanalization.
MedLine Citation:
PMID:  20090322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several angiographic patterns distal to severe M1 stenosis have been identified. We have assessed the relationship between these angiographic patterns and patient presenting symptoms, infarct patterns, perfusion status and outcome after recanalization. METHODS: Three angiographic patterns were retrospectively identified in 60 patients (M:F = 41:19; age range = 34-80 years, mean = 55) who underwent M1 stenting: (1) a normal pattern (n = 22); (2) a shift pattern of the borderzone of the anterior cerebral artery (ACA) and middle cerebral artery (MCA) down to the MCA side with decreased size of MCA branches (n = 16), and (3) a dilatation pattern of the MCA branches with slow flow and minimal shift of borderzone (n = 22). In addition, to analyze interreader agreement, we assessed the correlation between angiographic patterns and gender, presenting symptoms (stroke vs. TIA), infarct patterns on MRI (borderzone vs. non-borderzone infarcts), perfusion results and outcome after stenting by chi(2) or Fisher's exact test. RESULTS: Blind review revealed an excellent interreader agreement in the assessment of angiographic patterns (kappa = 0.681). The shift pattern was more common in women than in men (p = 0.007). The likelihood of stroke (25/60, 42%, p = 0.001), borderzone infarct (21/32, 66%, p = 0.010) and decreased perfusion (p < 0.001) were greatest in the dilatation pattern, followed by shift and normal patterns. The outcomes did not differ by angiographic pattern probably due to the low event rate (4/60, 6.7%) within 6 months. CONCLUSIONS: Patients with severe M1 stenosis had 3 different angiographic patterns, which correlated with presenting symptoms, infarct patterns and perfusion status. Differences in patterns may be related to variation in collateral circulation at the ACA-MCA borderzone and hypoperfusion status.
Authors:
Jin Woo Choi; Jae Kyun Kim; Byung Se Choi; Hyun-Kyung Lim; Sang Joon Kim; Jong Sung Kim; Dae Chul Suh
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-15
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  29     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  297-303     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anterior Cerebral Artery / physiopathology,  radiography*
Cerebral Angiography*
Cerebral Infarction / etiology*,  physiopathology,  therapy
Cerebrovascular Circulation*
Collateral Circulation
Constriction, Pathologic
Cross-Sectional Studies
Diffusion Magnetic Resonance Imaging
Dilatation, Pathologic
Female
Humans
Intracranial Arteriosclerosis / complications,  diagnosis,  physiopathology,  radiography*,  therapy
Magnetic Resonance Angiography
Male
Middle Aged
Middle Cerebral Artery / physiopathology,  radiography*
Observer Variation
Predictive Value of Tests
Registries
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Stents
Time Factors
Tomography, Emission-Computed, Single-Photon
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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