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[Multicenter Study on the Frequency of Large Vessel Occlusion in Patients with Minor Stroke]

Pablo Ros-Arlanzón1,2, Diego Corona García1,2, Raquel Hernández Lorido1,2

  • 1Departamento de Neurología, Hospital General Universitario Dr. Balmis, 03010 Alicante, España.

Revista De Neurologia
|April 29, 2025
PubMed

Insights

Computed tomography angiography (CTA) is crucial for identifying large vessel occlusion (LVO) in minor ischemic stroke patients. This imaging can alter clinical management in nearly half of affected individuals.

Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Minor ischemic stroke management faces challenges due to inconsistent neuroimaging and endovascular treatment (EVT) protocols.
  • Lack of consensus on computed tomography angiography (CTA) necessity for minor strokes underscores the need to study large vessel occlusion (LVO) prevalence.

Purpose of the Study:

  • To investigate the prevalence and clinical implications of large vessel occlusion (LVO) in patients experiencing minor ischemic stroke.
  • To evaluate the utility of CTA in identifying LVO in this patient population.

Main Methods:

  • Analysis of the multicenter CODICT registry (July 2020–November 2023) of minor ischemic stroke patients (NIHSS ≤5) at tertiary stroke alert centers.
  • CTA was used to assess the frequency of LVO in the internal carotid artery, vertebral artery, basilar artery, and critical cerebral artery segments (M1-M2, A1-A2, P1-P2).

Main Results:

  • Of 833 minor stroke patients, 17.5% had LVO detected by CTA.
  • Endovascular treatment (EVT) was performed in 48.6% of minor stroke patients with LVO.
  • The middle cerebral artery (MCA) M1 and M2 segments were most frequently occluded (35.6%), with M1 being the most common site for EVT (29.5%).

Conclusions:

  • CTA is important for all patients meeting stroke alert criteria, irrespective of clinical severity.
  • The identification of LVO significantly influenced clinical management in nearly 50% of minor stroke cases.
Abstract

Keywords:
computed tomography angiographylarge vessel occlusionminor strokestroke

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