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01-12-2020 | Stroke | Research article

Atherosclerotic plaque locations may be related to different ischemic lesion patterns

Authors: Ho Geol Woo, Sung Hyuk Heo, Eui Jong Kim, Dae-il Chang, Tae Jin Song, Bum Joon Kim

Published in: BMC Neurology | Issue 1/2020

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Abstract

Background

Atherosclerosis of the internal carotid artery (ICA) is an important cause of ischemic stroke. Artery-to-artery embolism is the major stroke mechanism in patients with atherosclerotic carotid disease. This study hypothesized that the atherosclerotic ICA geometry and plaque location would be associated with lesion pattern in patients with acute ischemic stroke.

Methods

Ischemic stroke patients with symptomatic proximal ICA disease (> 50% diameter stenosis) were enrolled. The carotid plaque location was divided into high-apical and low-body types. The geometric parameters of the ICA (angles between arteries) were measured, and ischemic lesion patterns were classified according to the number, location, and size of the lesions. Factors associated with plaque location and lesion pattern, dichotomized by size, were investigated.

Results

Of the 93 acute ischemic stroke patients enrolled, 31 had high-apical and 62 had low-body plaques. Hyperlipidemia was more prevalent and the common carotid artery (CCA)-ICA angle was wider (167.7 ± 10.4° vs 162.3 ± 9.8°, p = 0.019) in patients with low-body than high-apical plaques. Low-body plaques were more frequently associated with small scattered or cortical lesions (54.8% vs. 32.3%, p = 0.040), whereas high-apical plaques were more frequently associated with large lesions having additional lesions (38.7% vs. 11.3%, p = 0.002). The presence of low-body plaques (odds ratio: 3.106, 95% confidence interval: 1.105–8.728, p = 0.032) was independently associated with the small lesion-only pattern.

Conclusions

Low-body plaques are more frequently associated with small scattered lesions, whereas high-apical plaques are more frequently associated with large lesions having additional lesions. A wide CCA-ICA angle is associated with low-body plaque of the carotid artery.

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Title: Atherosclerotic plaque locations may be related to different ischemic lesion patterns
Authors: Ho Geol Woo
Sung Hyuk Heo
Eui Jong Kim
Dae-il Chang
Tae Jin Song
Bum Joon Kim
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Stroke
Pica Syndrome
Arterial Occlusive Disease
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01868-0

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