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Association between vertebrobasilar artery calcification and artery-to-artery embolism in the posterior circulation

Huan Yang1,2, Haoyu Lu3, Chen Xue4

  • 1Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Scientific Reports
|July 2, 2025
PubMed

Insights

Calcification patterns in vertebrobasilar artery atherosclerosis predict artery-to-artery embolism (AAE) stroke. Specific calcifications like spotty and intimal-predominant types increase AAE risk, aiding stroke prevention.

Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Science

Background:

  • Vertebrobasilar artery atherosclerosis is a significant cause of stroke.
  • Artery-to-artery embolism (AAE) infarction is a critical stroke subtype.
  • Understanding culprit lesion characteristics is vital for stroke mechanism identification.

Purpose of the Study:

  • To investigate calcification patterns in culprit lesions of patients with vertebrobasilar artery atherosclerosis.
  • To determine the association between calcification characteristics and artery-to-artery embolism (AAE) infarction.
  • To explore the role of vessel wall imaging in characterizing these lesions.

Main Methods:

  • Retrospective analysis of 151 stroke patients undergoing vessel wall magnetic resonance imaging (VW-MRI) and computed tomography (CT).
  • Categorization of patients into AAE (+) and AAE (-) groups based on stroke mechanism and ≥50% vertebrobasilar stenosis.
  • Multivariate logistic regression to assess the relationship between calcification features and AAE (+).

Main Results:

  • 56% of patients were classified as AAE (+).
  • Spotty calcification (presence and count), intimal-predominant calcification, and multiple calcifications were significantly associated with AAE (+).
  • Specific calcification characteristics at the culprit lesion correlated with posterior circulation infarction in AAE.

Conclusions:

  • Calcification patterns in vertebrobasilar atherosclerosis are linked to stroke mechanisms, particularly AAE infarction.
  • VW-MRI and CT reveal calcification features predictive of AAE.
  • Identifying these calcification patterns can enhance stroke prevention and treatment strategies.

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