[Related factors of internal border-zone infarcts in patients with symptomatic chronic internal carotid artery

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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

Published on: February 23, 2016

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G J Zhai1, Y Xu1, X Y Yang1

  • 1Department of Neurology, the Ninth People's Hospital of Suzhou, Suzhou 215200, China.

Zhonghua Yi Xue Za Zhi
|October 8, 2022
PubMed

Insights

Ophthalmic artery (OA) reflux, low-density lipoprotein (LDL), and prior cerebral infarction increase internal border-zone (IBZ) infarct risk in symptomatic chronic internal carotid artery occlusion (CICAO). Good collateral compensation and normal prothrombin international normalized ratio (INR) are protective.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Radiology

Background:

  • Symptomatic chronic internal carotid artery occlusion (CICAO) poses a significant risk for ischemic stroke.
  • Internal border-zone (IBZ) infarcts represent a specific pattern of brain injury in CICAO patients.
  • Understanding the factors contributing to IBZ infarcts is crucial for risk stratification and prevention.

Purpose of the Study:

  • To identify and analyze the factors associated with the occurrence of internal border-zone (IBZ) infarcts.
  • To investigate the relationship between demographic, laboratory, and imaging data and IBZ infarcts in symptomatic CICAO patients.

Main Methods:

  • Retrospective analysis of 185 symptomatic CICAO patients from January 2011 to May 2019.
  • Patients were categorized into internal border-zone (IBZ) infarct and non-IBZ infarct groups.
  • Binary logistic regression was employed to determine independent risk and protective factors for IBZ infarcts.

Main Results:

  • Ophthalmic artery (OA) reflux was significantly more prevalent in the IBZ group (64.1%) compared to the non-IBZ group (47.8%).
  • Collateral compensation (ASTIN/SIR 3-4) was significantly higher in the non-IBZ group (66.1%) versus the IBZ group (29.7%).
  • Independent risk factors for IBZ infarcts included history of cerebral infarction (OR=2.233), low-density lipoprotein (LDL) (OR=1.516), and OA reflux (OR=5.060). Prothrombin international normalized ratio (INR) (OR=0.010) and collateral compensation (OR=0.172) were protective.

Conclusions:

  • Ophthalmic artery (OA) reflux, elevated low-density lipoprotein (LDL) levels, and a history of cerebral infarction are significant independent risk factors for internal border-zone (IBZ) infarcts in symptomatic CICAO.
  • Adequate collateral compensation and a normal prothrombin international normalized ratio (INR) demonstrate a protective effect against IBZ infarcts in this patient cohort.

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