Related Experiment Video

Updated: Jan 29, 2026

Focal Cerebral Ischemia Model by Endovascular Suture Occlusion of the Middle Cerebral Artery in the Rat
13:50

Focal Cerebral Ischemia Model by Endovascular Suture Occlusion of the Middle Cerebral Artery in the Rat

Published on: February 5, 2011

80.9K

CTA-Based Truncal-Type Occlusion Is Best Matched With Postprocedural Fixed Focal Stenosis in Vertebrobasilar

Seong-Joon Lee1, Ji Man Hong1, Jin Wook Choi2

  • 1Department of Neurology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, South Korea.

Frontiers in Neurology
|February 12, 2019
PubMed

Insights

Differentiating embolic from atherosclerotic occlusions in acute ischemic stroke is challenging. Preprocedural CT angiography (CTA) truncal-type occlusion (TTO) identification shows good agreement with postprocedural fixed focal stenosis (FFS) in vertebrobasilar and middle cerebral artery M1 occlusions, aiding treatment planning.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Imaging

Background:

  • Distinguishing between embolic and atherosclerotic occlusions in acute ischemic stroke prior to endovascular treatment (EVT) is clinically challenging.
  • Computed tomography angiography (CTA)-determined occlusion type may predict underlying intracranial atherosclerosis (ICAS) and treatment outcomes.
  • Preprocedural identification of truncal-type occlusion (TTO) using CTA requires validation against postprocedural assessments of fixed focal stenosis (FFS).

Purpose of the Study:

  • To evaluate the agreement between preprocedural CTA-determined truncal-type occlusion (TTO) and postprocedural angiographic evaluation of fixed focal stenosis (FFS).
  • To assess the diagnostic performance of TTO as a surrogate marker for ICAS-related occlusions in different intracranial vascular beds.

Main Methods:

  • Retrospective analysis of 509 patients undergoing EVT for acute ischemic stroke within 24 hours of onset, with baseline CTA.
  • Preprocedural CTA classified occlusions as TTO (bifurcation saved) or branching-site occlusion (bifurcation involved).
  • Postprocedural angiography assessed for fixed focal stenosis (FFS); agreement evaluated using receiver operating characteristic (ROC) analyses.

Main Results:

  • Good agreement between TTO and FFS was observed in the middle cerebral artery (MCA) M1 segment (AUC 0.671) and vertebrobasilar artery (VBA) (AUC 0.872).
  • Positive predictive values for TTO indicating FFS were 63.4% for MCA M1 and 72.4% for VBA.
  • No significant association was found between TTO and FFS in intracranial internal carotid artery (ICA) occlusions (AUC 0.551).

Conclusions:

  • Preprocedural CTA-determined TTO is a reliable surrogate marker for ICAS-related occlusions in VBA and MCA M1 occlusions.
  • The diagnostic utility of TTO for identifying underlying atherosclerosis is highest in the VBA, followed by MCA M1.
  • CTA-based TTO identification lacks significant association with FFS in intracranial ICA occlusions, suggesting different underlying etiologies.

Keywords:
computed tomographic angiographyendovascular treatmentintracranial atherosclerosisintracranial atherosclerotic stenosistruncal-type occlusion

More Related Videos

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock06:30

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

Published on: May 19, 2022

7.7K
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia07:46

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

30.2K

Related Concept Videos

Sign Test for Matched Pairs01:17

Sign Test for Matched Pairs

The sign test for matched pairs offers a robust method for comparing two paired samples, often for the effects of an intervention in one of them. This method is very useful in situations where the underlying distribution of the data is unknown. The test compares two related samples—often pre- and post-treatment measurements on the same subjects—to determine if there are significant differences in their median values.
To conduct the sign test, we first calculate the differences in...
405
Fixing Double-strand Breaks02:04

Fixing Double-strand Breaks

The double-stranded structure of DNA has two major advantages. First, it serves as a safe repository of genetic information where one strand serves as the back-up in case the other strand is damaged. Second, the double-helical structure can be wrapped around proteins called histones to form nucleosomes, which can then be tightly wound to form chromosomes. This way, DNA chains up to 2 inches long can be contained within microscopic structures in a cell. A double-stranded break not only damages...
14.6K
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
592
Fixed Action Patterns01:06

Fixed Action Patterns

A fixed action pattern (FAP) is a specific, hard-wired sequence of behaviors that occurs in response to an external stimulus, called a sign stimulus. The behavior is “fixed” because it is essentially unchangeable—proceeding similarly across individuals of a species every time it occurs.
17.6K
Wilcoxon Signed-Ranks Test for Matched Pairs01:09

Wilcoxon Signed-Ranks Test for Matched Pairs

The Wilcoxon signed-rank test for matched pairs evaluates the null hypothesis by combining the ranks of differences with their signs. It essentially tests whether the median of the differences in a population of matched pairs is zero. Since the test incorporates more information than the sign test, it generally yields more trustable conclusions. This test also does not require the data to follow a normal distribution, but two conditions must be met for it to be applicable: (1) the data must...
491
Intracellular Signaling Affects Focal Adhesions01:17

Intracellular Signaling Affects Focal Adhesions

Integrins act both as extracellular input receivers and as intracellular processing activators. As their name suggests, integrins are entirely integrated into the membrane structure. Their hydrophobic membrane-spanning regions interact with the phospholipid bilayer's hydrophobic region. These membrane receptors provide extracellular attachment sites for effectors like hormones and growth factors. They activate intracellular response cascades when their effectors are bound and active.
Some...
3.6K