Cerebral hemodynamics and stroke risks in symptomatic intracranial atherosclerotic stenosis with internal versus cortical borderzone infarcts : A computational fluid dynamics study
There may be different mechanisms underlying internal (IBZ) and cortical (CBZ) borderzone infarcts in intracranial atherosclerotic stenosis. In 84 patients with symptomatic, 50-99% atherosclerotic stenosis of M1 middle cerebral artery (MCA-M1) with acute borderzone infarcts in diffusion-weighted imaging, we classified the infarct patterns as isolated IBZ (n = 37), isolated CBZ (n = 31), and IBZ+CBZ (n = 16) infarcts. CT angiography-based computational fluid dynamics models were constructed to quantify translesional, post-stenotic to pre-stenotic pressure ratio (PR) in the MCA-M1 lesion. Those with IBZ infarcts were more likely to have a low PR (indicating impaired antegrade flow across the lesion) than those without (p = 0.012), and those with CBZ infarcts were more likely to have coexisting small cortical infarcts (indicating possible embolism) than those without (p = 0.004). In those with isolated IBZ or CBZ infarcts, low PR was independently associated with isolated IBZ infarcts (adjusted odds ratio = 4.223; p = 0.026). These two groups may also have different trajectories in the stroke risks under current medical treatment regimen, with a higher risk of same-territory ischemic stroke recurrence within 3 months in patients with isolated IBZ infarcts than isolated CBZ infarcts (17.9% versus 0.0%; log-rank p = 0.023), but similar risks later in 1 year.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism - 44(2024), 4 vom: 01. Apr., Seite 516-526 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Li, Shuang [VerfasserIn] |
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| Links: |
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| Themen: |
Borderzone infarct |
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| Anmerkungen: |
Date Completed 28.03.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0271678X231211449 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363901191 |
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| 100 | 1 | |a Li, Shuang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cerebral hemodynamics and stroke risks in symptomatic intracranial atherosclerotic stenosis with internal versus cortical borderzone infarcts |b A computational fluid dynamics study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a There may be different mechanisms underlying internal (IBZ) and cortical (CBZ) borderzone infarcts in intracranial atherosclerotic stenosis. In 84 patients with symptomatic, 50-99% atherosclerotic stenosis of M1 middle cerebral artery (MCA-M1) with acute borderzone infarcts in diffusion-weighted imaging, we classified the infarct patterns as isolated IBZ (n = 37), isolated CBZ (n = 31), and IBZ+CBZ (n = 16) infarcts. CT angiography-based computational fluid dynamics models were constructed to quantify translesional, post-stenotic to pre-stenotic pressure ratio (PR) in the MCA-M1 lesion. Those with IBZ infarcts were more likely to have a low PR (indicating impaired antegrade flow across the lesion) than those without (p = 0.012), and those with CBZ infarcts were more likely to have coexisting small cortical infarcts (indicating possible embolism) than those without (p = 0.004). In those with isolated IBZ or CBZ infarcts, low PR was independently associated with isolated IBZ infarcts (adjusted odds ratio = 4.223; p = 0.026). These two groups may also have different trajectories in the stroke risks under current medical treatment regimen, with a higher risk of same-territory ischemic stroke recurrence within 3 months in patients with isolated IBZ infarcts than isolated CBZ infarcts (17.9% versus 0.0%; log-rank p = 0.023), but similar risks later in 1 year | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Borderzone infarct | |
| 650 | 4 | |a cerebral hemodynamics | |
| 650 | 4 | |a intracranial atherosclerotic disease | |
| 650 | 4 | |a ischemic stroke | |
| 650 | 4 | |a prognosis | |
| 700 | 1 | |a Tian, Xuan |e verfasserin |4 aut | |
| 700 | 1 | |a Ip, Bonaventure |e verfasserin |4 aut | |
| 700 | 1 | |a Feng, Xueyan |e verfasserin |4 aut | |
| 700 | 1 | |a Ip, Hing Lung |e verfasserin |4 aut | |
| 700 | 1 | |a Abrigo, Jill |e verfasserin |4 aut | |
| 700 | 1 | |a Lan, Linfang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Haipeng |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Lina |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yuying |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Karen Ky |e verfasserin |4 aut | |
| 700 | 1 | |a Fan, Florence Sy |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Sze Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Fang, Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Yuming |e verfasserin |4 aut | |
| 700 | 1 | |a Lau, Alexander Y |e verfasserin |4 aut | |
| 700 | 1 | |a Leung, Howan |e verfasserin |4 aut | |
| 700 | 1 | |a Soo, Yannie Oy |e verfasserin |4 aut | |
| 700 | 1 | |a Mok, Vincent Ct |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Ka Sing |e verfasserin |4 aut | |
| 700 | 1 | |a Leng, Xinyi |e verfasserin |4 aut | |
| 700 | 1 | |a Leung, Thomas W |e verfasserin |4 aut | |
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