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Prevalence and Distribution of Intracranial Vessel Occlusion on Angiography and Its Association with Functional

Alexander P Benz1,2, Thomas R Meinel3, Alexander Salerno4

  • 1Population Health Research Institute, McMaster University, Hamilton, Canada.

Annals of Neurology
|September 30, 2024
PubMed

Insights

Intracranial vessel occlusion is common in patients with atrial fibrillation and ischemic stroke, significantly increasing the risk of poor functional outcomes. Early identification and treatment are crucial for improving patient prognosis.

Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Atrial fibrillation (AF) is a major risk factor for ischemic stroke.
  • Intracranial vessel occlusion (IVO) is a critical determinant of stroke severity and outcome.
  • Understanding the prevalence and impact of IVO in AF patients is essential for stroke management.

Purpose of the Study:

  • To determine the prevalence and distribution of IVO in patients with AF and ischemic stroke using CT or MR angiography.
  • To explore the association between IVO and functional outcomes at 90 days post-stroke.

Main Methods:

  • Multicenter cohort study (2014-2022) of consecutive AF patients with imaging-confirmed ischemic stroke.
  • CT or MR angiography performed on admission to detect IVO.
  • Multivariable regression analysis to assess the association between IVO and poor functional outcome (modified Rankin Scale score 3-6 at 90 days).

Main Results:

  • 51.1% of 10,164 AF patients with ischemic stroke had IVO, predominantly in the anterior circulation (87.4%).
  • Poor functional outcome at 90 days was more common in patients with IVO (60.6%) compared to those without (42.7%).
  • IVO was independently associated with poor functional outcome (aOR: 1.95; 95% CI: 1.71-2.22), regardless of oral anticoagulation status.

Conclusions:

  • Intracranial vessel occlusion is highly prevalent in AF patients experiencing ischemic stroke.
  • IVO is a significant predictor of poor functional outcomes in this patient population.
  • Findings underscore the importance of advanced imaging for diagnosing IVO and guiding stroke treatment strategies.
Abstract

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