Plaque morphology in acute symptomatic intracranial atherosclerotic disease

Journal of Neurology, Neurosurgery & Psychiatry

Fecha de publicación: Abril de 2021

DOI: doi:10.1016/S1474-4422(13)70195-9

Autores: Thomas W Leung, Li Wang, Xinying Zou, Yannie Soo, Yuehua Pu, Hing Lung Ip, Anne Chan, Lisa Wing Chi Au, Florence Fan, Sze Ho Ma, Bonaventure Ip, Karen Ma, Alexander Yuk-lun Lau, Howan Leung, Kwok Fai Hui, Richard Li, Siu Hung Li, Michael Fu, Wing Chi Fong, Jia Liu, Vincent Mok, Ka Sing Lawrence Wong, Zhongrong Miao, Ning Ma, Simon C H Yu, Xinyi Leng

Background: Intracranial atherosclerotic disease (ICAD) is globally a major ischaemic stroke subtype with high recurrence. Understanding the morphology of symptomatic ICAD plaques, largely unknown by far, may help identify vulnerable lesions prone to relapse. Methods: We prospectively recruited patients with acute ischaemic stroke or transient ischaemic attack attributed to high-grade ICAD (60%–99% stenosis). Plaque morphological parameters were assessed in three-dimensional rotational angiography, including surface contour, luminal stenosis, plaque length/thickness, upstream shoulder angulation, axial/longitudinal plaque distribution and presence of adjoining branch atheromatous disease (BAD). We compared morphological features of smooth, irregular and ulcerative plaques and correlated them with cerebral ischaemic lesion load downstream in MRI.

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