Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome
Background and PurposeSymptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known.MethodsWe retrospectively identified 3,451 patients h...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Stroke Society
2014-01-01
|
| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-16-36.pdf |
| _version_ | 1818610521972146176 |
|---|---|
| author | Jihoon Kang Tai Hwan Park Kyung Bok Lee Jong-Moo Park Youngchai Ko Soo Joo Lee Keun-Sik Hong Yong-Jin Cho Ji Sung Lee Juneyoung Lee Byung-Chul Lee Kyung-Ho Yu Dae-Hyun Kim Jae-Kwan Cha Jun Lee Myung Suk Jang Moon-Ku Han Hee-Joon Bae |
| author_facet | Jihoon Kang Tai Hwan Park Kyung Bok Lee Jong-Moo Park Youngchai Ko Soo Joo Lee Keun-Sik Hong Yong-Jin Cho Ji Sung Lee Juneyoung Lee Byung-Chul Lee Kyung-Ho Yu Dae-Hyun Kim Jae-Kwan Cha Jun Lee Myung Suk Jang Moon-Ku Han Hee-Joon Bae |
| author_sort | Jihoon Kang |
| collection | DOAJ |
| description | Background and PurposeSymptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known.MethodsWe retrospectively identified 3,451 patients hospitalized because of ischemic stroke within 24 hours of symptom onset at 9 stroke centers in South Korea. Patients who did not undergo magnetic resonance imaging were excluded. SYSO was defined as stenosis or occlusion of cerebral arteries with relevant ischemic lesions in the corresponding arterial territory. The number, location, and severity of SYSOs and their effects on functional outcome were analyzed.ResultsIn total, 1,929 of 3,057 subjects (63.1%) had SYSO. The most frequently affected vessels were the middle cerebral artery (34.6%), extracranial internal carotid artery (14%), vertebral artery (12.4%), and basilar artery (8.7%). SYSO predicted poor outcome on the modified Rankin Scale 3-6 (odds ratio, 1.77; 95% confidence interval, 1.46-2.15) with adjustments. Involvement of 2 or more vessels was observed in 30.6% of patients with SYSO and independently increased the risk of poor outcome (odds ratio, 2.76; 95% confidence interval, 2.12-3.59). The severity of SYSO was associated with outcome and showed a significant dose-response trend (P<0.001). The effect of SYSO on outcome did not significantly differ by individual arterial location (P for contrast=0.21).ConclusionsApproximately 60% of patients with acute ischemic stroke had SYSO, and the severity and number were inversely correlated with outcome. The results suggest that SYSO could predict stroke outcome. |
| first_indexed | 2024-12-16T15:15:46Z |
| format | Article |
| id | doaj.art-2093ab4e5a974cefa3cc1c6e5de091a6 |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-12-16T15:15:46Z |
| publishDate | 2014-01-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-2093ab4e5a974cefa3cc1c6e5de091a62022-12-21T22:26:48ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052014-01-01161364310.5853/jos.2014.16.1.3640Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional OutcomeJihoon KangTai Hwan ParkKyung Bok LeeJong-Moo ParkYoungchai KoSoo Joo LeeKeun-Sik HongYong-Jin ChoJi Sung LeeJuneyoung LeeByung-Chul LeeKyung-Ho YuDae-Hyun KimJae-Kwan ChaJun LeeMyung Suk JangMoon-Ku HanHee-Joon BaeBackground and PurposeSymptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known.MethodsWe retrospectively identified 3,451 patients hospitalized because of ischemic stroke within 24 hours of symptom onset at 9 stroke centers in South Korea. Patients who did not undergo magnetic resonance imaging were excluded. SYSO was defined as stenosis or occlusion of cerebral arteries with relevant ischemic lesions in the corresponding arterial territory. The number, location, and severity of SYSOs and their effects on functional outcome were analyzed.ResultsIn total, 1,929 of 3,057 subjects (63.1%) had SYSO. The most frequently affected vessels were the middle cerebral artery (34.6%), extracranial internal carotid artery (14%), vertebral artery (12.4%), and basilar artery (8.7%). SYSO predicted poor outcome on the modified Rankin Scale 3-6 (odds ratio, 1.77; 95% confidence interval, 1.46-2.15) with adjustments. Involvement of 2 or more vessels was observed in 30.6% of patients with SYSO and independently increased the risk of poor outcome (odds ratio, 2.76; 95% confidence interval, 2.12-3.59). The severity of SYSO was associated with outcome and showed a significant dose-response trend (P<0.001). The effect of SYSO on outcome did not significantly differ by individual arterial location (P for contrast=0.21).ConclusionsApproximately 60% of patients with acute ischemic stroke had SYSO, and the severity and number were inversely correlated with outcome. The results suggest that SYSO could predict stroke outcome.http://www.j-stroke.org/upload/pdf/jos-16-36.pdfcerebrovascular occlusionstrokecerebral arteriesmagnetic resonance imaging |
| spellingShingle | Jihoon Kang Tai Hwan Park Kyung Bok Lee Jong-Moo Park Youngchai Ko Soo Joo Lee Keun-Sik Hong Yong-Jin Cho Ji Sung Lee Juneyoung Lee Byung-Chul Lee Kyung-Ho Yu Dae-Hyun Kim Jae-Kwan Cha Jun Lee Myung Suk Jang Moon-Ku Han Hee-Joon Bae Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome Journal of Stroke cerebrovascular occlusion stroke cerebral arteries magnetic resonance imaging |
| title | Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome |
| title_full | Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome |
| title_fullStr | Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome |
| title_full_unstemmed | Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome |
| title_short | Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome |
| title_sort | symptomatic steno occlusion in patients with acute cerebral infarction prevalence distribution and functional outcome |
| topic | cerebrovascular occlusion stroke cerebral arteries magnetic resonance imaging |
| url | http://www.j-stroke.org/upload/pdf/jos-16-36.pdf |
| work_keys_str_mv | AT jihoonkang symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT taihwanpark symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT kyungboklee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT jongmoopark symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT youngchaiko symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT soojoolee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT keunsikhong symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT yongjincho symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT jisunglee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT juneyounglee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT byungchullee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT kyunghoyu symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT daehyunkim symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT jaekwancha symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT junlee symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT myungsukjang symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT moonkuhan symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome AT heejoonbae symptomaticstenoocclusioninpatientswithacutecerebralinfarctionprevalencedistributionandfunctionaloutcome |