Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke

[Background and Purpose] The influence of intracranial arteriosclerosis (ICAR) on acute ischaemic stroke (AIS) prognosis is unclear. This study explored its impact, focusing on ICAR subtypes categorized by intracranial carotid artery calcification (ICAC) patterns: intimal or atherosclerotic versus i...

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Autores: Sierra-Gómez, Alicia, Ramos-Araque, María E., Luijten, Sven P. R., Lera Alfonso, Mercedes de, Calleja, Ana I., Valle-Peñacoba, Gonzalo, Gómez-Vicente, Beatriz, Reyes, Javier, Martínez-Galdámez, Mario, Galván, Jorge, Schüller, Miguel, Pérez Sánchez, Lorenzo, Bos, Daniel, Arenillas, Juan F.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:dnet:digitalcsic_::b841576e581e11bbef764eb28833ff81
Acceso en línea:http://hdl.handle.net/10261/431876
Access Level:acceso abierto
Palabra clave:Acute ischaemic stroke
Endovascular treatment
Internal elastic lamina calcification
Intimal calcification
Intracranial arteriosclerosis
Intracranial atherosclerosis
Itracranial carotid artery calcification
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spelling Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic strokeSierra-Gómez, AliciaRamos-Araque, María E.Luijten, Sven P. R.Lera Alfonso, Mercedes deCalleja, Ana I.Valle-Peñacoba, GonzaloGómez-Vicente, BeatrizReyes, JavierMartínez-Galdámez, MarioGalván, JorgeSchüller, MiguelPérez Sánchez, LorenzoBos, DanielArenillas, Juan F.Acute ischaemic strokeEndovascular treatmentInternal elastic lamina calcificationIntimal calcificationIntracranial arteriosclerosisIntracranial atherosclerosisItracranial carotid artery calcification[Background and Purpose] The influence of intracranial arteriosclerosis (ICAR) on acute ischaemic stroke (AIS) prognosis is unclear. This study explored its impact, focusing on ICAR subtypes categorized by intracranial carotid artery calcification (ICAC) patterns: intimal or atherosclerotic versus internal elastic lamina calcification or non-atherosclerotic. The aim was to determine their effect on AIS prognosis in patients undergoing endovascular treatment (EVT).[Methods] This prospective cohort study included consecutive AIS patients with anterior circulation large vessel occlusion undergoing EVT. ICAC, the hallmark of ICAR, was assessed using non-contrast computed tomography to quantify volume and establish the predominant ICAR subtype. The primary outcome was long-term functional outcome, measured by the 90-day modified Rankin Scale score. Secondary outcomes included first-pass effect, revascularization degree, symptomatic intracranial haemorrhage and 24-h infarct volume. Multivariate-adjusted linear and logistic regression models were used to assess the association of ICAC volume and subtype with these outcomes.[Results] From January 2021 to February 2022, 181 patients were included, of whom 172 (95%) had ICAC. Internal elastic lamina calcification was the predominant subtype in 103 (57%), intimal in 52 (29%) and mixed in 17 (9%). The intimal or atherosclerotic ICAC pattern was linked to poorer functional outcomes (adjusted odds ratio 2.12, 95% confidence interval [CI] 1.10–4.09), decreased first-pass effect probability (adjusted odds ratio 0.42, 95% CI 0.21–0.84) and higher infarct volume (adjusted β value 22.11, 95% CI 0.55–43.67).[Conclusions] A predominant intimal ICAC subtype, linked to underlying atherosclerosis, correlated with larger infarct volume and poorer 90-day functional outcomes in EVT-treated AIS patients. Intracranial atherosclerosis appears to be a relevant factor hampering clinical benefits post-EVT.Instituto de Salud Carlos III, Grant/Award Number: CM21/00163, JR19/00020, PI19-01398, RD21/0006/0005 and RD21/0006/0020Peer reviewedS. Karger AGInstituto de Salud Carlos III202620262025info:eu-repo/semantics/articlePublisher's versioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10261/431876reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)InglésThe underlying dataset has been published as supplementary material of the article in the publisher platform at DOI https://doi.org/10.1111/ene.16509https://doi.org/10.1111/ene.16509Síinfo:eu-repo/semantics/openAccessoai:dnet:digitalcsic_::b841576e581e11bbef764eb28833ff812026-05-22T06:33:51Z
dc.title.none.fl_str_mv Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
title Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
spellingShingle Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
Sierra-Gómez, Alicia
Acute ischaemic stroke
Endovascular treatment
Internal elastic lamina calcification
Intimal calcification
Intracranial arteriosclerosis
Intracranial atherosclerosis
Itracranial carotid artery calcification
title_short Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
title_full Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
title_fullStr Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
title_full_unstemmed Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
title_sort Prognostic impact of intracranial arteriosclerosis subtype after endovascular treatment for acute ischaemic stroke
dc.creator.none.fl_str_mv Sierra-Gómez, Alicia
Ramos-Araque, María E.
Luijten, Sven P. R.
Lera Alfonso, Mercedes de
Calleja, Ana I.
Valle-Peñacoba, Gonzalo
Gómez-Vicente, Beatriz
Reyes, Javier
Martínez-Galdámez, Mario
Galván, Jorge
Schüller, Miguel
Pérez Sánchez, Lorenzo
Bos, Daniel
Arenillas, Juan F.
author Sierra-Gómez, Alicia
author_facet Sierra-Gómez, Alicia
Ramos-Araque, María E.
Luijten, Sven P. R.
Lera Alfonso, Mercedes de
Calleja, Ana I.
Valle-Peñacoba, Gonzalo
Gómez-Vicente, Beatriz
Reyes, Javier
Martínez-Galdámez, Mario
Galván, Jorge
Schüller, Miguel
Pérez Sánchez, Lorenzo
Bos, Daniel
Arenillas, Juan F.
author_role author
author2 Ramos-Araque, María E.
Luijten, Sven P. R.
Lera Alfonso, Mercedes de
Calleja, Ana I.
Valle-Peñacoba, Gonzalo
Gómez-Vicente, Beatriz
Reyes, Javier
Martínez-Galdámez, Mario
Galván, Jorge
Schüller, Miguel
Pérez Sánchez, Lorenzo
Bos, Daniel
Arenillas, Juan F.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Acute ischaemic stroke
Endovascular treatment
Internal elastic lamina calcification
Intimal calcification
Intracranial arteriosclerosis
Intracranial atherosclerosis
Itracranial carotid artery calcification
topic Acute ischaemic stroke
Endovascular treatment
Internal elastic lamina calcification
Intimal calcification
Intracranial arteriosclerosis
Intracranial atherosclerosis
Itracranial carotid artery calcification
description [Background and Purpose] The influence of intracranial arteriosclerosis (ICAR) on acute ischaemic stroke (AIS) prognosis is unclear. This study explored its impact, focusing on ICAR subtypes categorized by intracranial carotid artery calcification (ICAC) patterns: intimal or atherosclerotic versus internal elastic lamina calcification or non-atherosclerotic. The aim was to determine their effect on AIS prognosis in patients undergoing endovascular treatment (EVT).
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/431876
url http://hdl.handle.net/10261/431876
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv The underlying dataset has been published as supplementary material of the article in the publisher platform at DOI https://doi.org/10.1111/ene.16509
https://doi.org/10.1111/ene.16509
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv S. Karger AG
publisher.none.fl_str_mv S. Karger AG
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869419328865042432
score 15,81155

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