Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging...

Area of Science:

• Neurology
• Radiology
• Vascular Medicine

Background:

• Intracranial arterial disease (ICAD) is a significant cause of ischemic stroke.
• The temporal evolution of vessel wall changes in ICAD is not well understood.
• Understanding these dynamics is crucial for predicting stroke recurrence and guiding treatment.

Purpose of the Study:

• To investigate the temporal changes in narrowed intracranial arteries following ischemic stroke.
• To compare the temporal dynamics of vessel wall changes based on the etiology of ICAD.

Main Methods:

• Retrospective analysis of patients with ICAD-related ischemic stroke undergoing serial high-resolution vessel wall imaging (HR-VWI).
• Manual segmentation of lumen area (LA), total vessel area (TVA), and enhancing area (EA) to calculate stenosis, enhancing proportion, and enhancement ratio.
• Linear mixed models used to assess temporal changes and differences between etiologies.

Main Results:

• Over a median follow-up of 319 days, degree of stenosis and enhancing proportion showed a trend to decrease.
• Intracranial dissection led to faster reductions in stenosis and enhancing proportion compared to atherosclerosis.
• Enhancement ratio decreased over time in atherosclerosis but remained stable in dissection.

Conclusions:

• Intracranial vessel narrowing exhibits distinct temporal changes following ischemic stroke, varying by etiology.
• Atherosclerosis and dissection demonstrate unique temporal progression patterns in ICAD.
• Serial HR-VWI is valuable for monitoring disease activity and understanding the natural history of ICAD.