Key result
Extracranial carotid artery maximum wall thickness was significantly associated with severe intracranial artery stenosis (adjusted OR 1.72; 95% CI 1.04-2.83; P=0.034).
Why the study?
Is extracranial carotid plaque burden associated with severe intracranial artery stenosis in patients with recent cerebrovascular symptoms?
Cross-Sectional (n=107)
Is extracranial carotid plaque burden associated with severe intracranial artery stenosis in patients with recent cerebrovascular symptoms?
Odds Ratio: 1.72 (95% CI 1.04–2.83)
p-value: p=0.034
Extracranial carotid plaque burden assessed by MR vessel wall imaging is significantly associated with severe intracranial artery stenosis, serving as a potential independent indicator of intracranial atherosclerosis severity.
Carotid plaque burden was associated with severe intracranial stenosis; leaves open shared mechanisms and warrants prospective validation before guiding imaging strategies.
Objective This study sought to investigate the relationship of atherosclerosis between intracranial and extracranial carotid arteries using three‐dimensional multicontrast magnetic resonance ( MR ) vessel wall imaging. Methods Patients with recent cerebrovascular symptoms in anterior circulation were recruited and underwent MR vessel wall imaging for intracranial and extracranial carotid arteries. The plaque burden, including maximum wall thickness (Max WT ) and stenosis, and presence of intraplaque hemorrhage ( IPH ) were assessed. The correlation of the plaque characteristics between intracranial and extracranial carotid arteries was determined. Results In total, 107 patients (mean age: 57.0 ± 11.1 years, 69 males) were recruited. In discriminating intracranial severe stenosis (≥50% stenosis), the odds ratio ( OR ) of Max WT of extracranial carotid arteries was 1.41 (95% confidence interval [ CI ], 0.94–2.11, P = 0.095) and 1.72 (95% CI , 1.04–2.83, P = 0.034) before and after adjusting for confounding factors, respectively. The OR of stenosis of extracranial carotid arteries with increment of 10% was 1.26 (95% CI , 0.99–1.60, P = 0.054) and 1.37 (95% CI , 1.03–1.82, P = 0.033) before and after adjusting for confounding factors, in discriminating intracranial severe stenosis respectively. Receiver operating characteristic analysis revealed that the area under the curve ( AUC ) of Max WT , stenosis, and IPH of extracranial carotid artery plaques was 0.641, 0.605, and 0.603 in discriminating intracranial severe stenosis, respectively. After adjusting for confounding factors, the AUC of Max WT , stenosis, and presence of IPH in extracranial carotid artery plaques increased to 0.812, 0.817 and 0.781, respectively. Interpretation Carotid artery plaque burden is significantly associated with severe intracranial artery stenosis, suggesting that extracranial carotid plaque burden might be an independent indicator for severity of intracranial artery atherosclerosis.
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Xu et al. (2018) conducted a cross-sectional in Recent cerebrovascular symptoms in anterior circulation (n=107). Extracranial carotid artery plaque burden (maximum wall thickness) was evaluated on Intracranial severe stenosis (≥50% stenosis) (OR 1.72, 95% CI 1.04-2.83, p=0.034). Extracranial carotid artery maximum wall thickness was significantly associated with severe intracranial artery stenosis (adjusted OR 1.72; 95% CI 1.04-2.83; P=0.034).
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