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Symptomatic intracranial atherosclerotic disease: an ultrasound 2-year follow-up pilot study

  • Pietro Caliandro
  • Giuseppe Reale
  • Andrew M. Demchuk
  • Valeria Caso
  • Anita Arsovska
  • Chiara Iacovelli
  • Silvia Giovannini
  • Paolo Maria Rossini
Brief Communication

Abstract

Introduction

The objective of this single-center pilot study was to assess if symptomatic intracranial atherosclerotic disease (ICAD) ultrasound features change through the 2 years after acute ischemic stroke or TIA, being ICAD a relevant cause of acute ischemic stroke or TIA, linked to high rates of recurrent stroke.

Methods

We consecutively enrolled 48 patients with acute ischemic stroke or TIA with symptomatic ICAD detected by transcranial color-coded duplex sonography (TCCS) and confirmed by MR-angiography and/or CT-angiography. We set a neurosonological and clinical follow-up at 3, 6, 12, and 24 months (T0, T1, T2, T3, and T4).

Results

We observed that the hemodynamic effect of the stenosis changed during the 2-year follow-up, as revealed by the modifications of Peak Systolic Velocity (PSV) (Friedman-ANOVA test, p < 0.001). The pairwise post-hoc analysis showed a statistically significant difference between PSV at T0 and PSV at T3 (p = 0.005) and between PSV at T0 and PSV at T4 (p < 0.001) being PSV at T3 and T4 lower than PSV at T0. Seven patients had a new event in the first 12 months.

Conclusions

The high rate of recurrent stroke or death among ICAD patients seems to be independent of progressive arterial narrowing. A wide multicenter follow-up study is needed in order to identify the factors that, alongside the hemodynamic features, contribute to the high risk of recurrent stroke among patient with symptomatic ICAD.

Keywords

Ischemic stroke Intracranial atherosclerotic disease Arterial stenosis Transcranial color-coded duplex sonography Ultrasound 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Unità Operativa Complessa di NeurologiaFondazione Policlinico Universitario A. Gemelli IRCCS, RomaRomeItaly
  2. 2.Institute of NeurologyFondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro CuoreRomeItaly
  3. 3.Hotchkiss Brain Institute, Department of Clinical Neurosciences and RadiologyUniversity of CalgaryCalgaryCanada
  4. 4.Division of Cardiovascular Medicine, Stroke UnitUniversity of PerugiaPerugiaItaly
  5. 5.University Clinic of NeurologySkopjeMacedonia
  6. 6.Fondazione Don Carlo Gnocchi OnlusMilanItaly
  7. 7.Unità Operativa Complessa Riabilitazione 2Fondazione Policlinico Universitario A. Gemelli IRCCS, RomaRomeItaly

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