Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians

A Prospective, Multicenter, Transcranial Doppler Study

Georgios Tsivgoulis, Konstantinos Vadikolias, Ioannis Heliopoulos, Chaido Katsibari, Konstantinos Voumvourakis, Soultana Tsakaldimi, Eleni Boutati, Spyros N. Vasdekis, Dimitrios Athanasiadis, Omar S. Al-Attas, Paris Charalampidis, Elefterios Stamboulis, Charitomeni Piperidou

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

BACKGROUND: There are limited data available regarding symptomatic intracranial atherosclerosis (SIA) prevalence in Caucasians. We sought to investigate SIA prevalence among Caucasian patients hospitalized with acute cerebral ischemia (ACI) in a prospective, multicenter Transcranial Doppler sonography (TCD) study. METHODS: Consecutive patients with ACI were prospectively evaluated with TCD over a 24-month-period. The previously validated criteria of SONIA trial were used for detection of >50% intracranial stenosis with TCD. Brain angiography was performed to confirm the diagnosis in cases with abnormal TCD findings. SIA was diagnosed when there was evidence of a cerebral infarction in the territory of the stenotic artery (identified by TCD and confirmed by Magnetic resonance angiography [MRA]/Computed tomography angiography [CTA]). RESULTS: A total of 467 consecutive patients with ACI (60.4% men, mean age 58 ± 14 years) were evaluated. SIA was documented in 43 patients (9.2%; 95%CI: 6.9%-12.2%). The most common SIA location was M1MCA (34.9%) followed by TICA (18.8%). Diabetes mellitus (OR: 4.25, 95%CI: 2.18-8.26; P < .001) and hypertension (OR: 2.41, 95%CI: 1.02-5.67; P = .045) were independently associated with SIA on multivariate models adjusting for potential confounders. CONCLUSIONS: SIA was identified in almost 10% of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI.

Original languageEnglish (US)
Pages (from-to)11-17
Number of pages7
JournalJournal of Neuroimaging
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Intracranial Arteriosclerosis
Doppler Transcranial Ultrasonography
Brain Ischemia
Magnetic Resonance Angiography
Cerebral Infarction
Diabetes Mellitus
Angiography
Pathologic Constriction
Arteries
Stroke
Hypertension
Physicians

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians : A Prospective, Multicenter, Transcranial Doppler Study. / Tsivgoulis, Georgios; Vadikolias, Konstantinos; Heliopoulos, Ioannis; Katsibari, Chaido; Voumvourakis, Konstantinos; Tsakaldimi, Soultana; Boutati, Eleni; Vasdekis, Spyros N.; Athanasiadis, Dimitrios; Al-Attas, Omar S.; Charalampidis, Paris; Stamboulis, Elefterios; Piperidou, Charitomeni.

In: Journal of Neuroimaging, Vol. 24, No. 1, 01.01.2014, p. 11-17.

Research output: Contribution to journalArticle

Tsivgoulis, G, Vadikolias, K, Heliopoulos, I, Katsibari, C, Voumvourakis, K, Tsakaldimi, S, Boutati, E, Vasdekis, SN, Athanasiadis, D, Al-Attas, OS, Charalampidis, P, Stamboulis, E & Piperidou, C 2014, 'Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians: A Prospective, Multicenter, Transcranial Doppler Study', Journal of Neuroimaging, vol. 24, no. 1, pp. 11-17. https://doi.org/10.1111/j.1552-6569.2012.00707.x
Tsivgoulis, Georgios ; Vadikolias, Konstantinos ; Heliopoulos, Ioannis ; Katsibari, Chaido ; Voumvourakis, Konstantinos ; Tsakaldimi, Soultana ; Boutati, Eleni ; Vasdekis, Spyros N. ; Athanasiadis, Dimitrios ; Al-Attas, Omar S. ; Charalampidis, Paris ; Stamboulis, Elefterios ; Piperidou, Charitomeni. / Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians : A Prospective, Multicenter, Transcranial Doppler Study. In: Journal of Neuroimaging. 2014 ; Vol. 24, No. 1. pp. 11-17.
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abstract = "BACKGROUND: There are limited data available regarding symptomatic intracranial atherosclerosis (SIA) prevalence in Caucasians. We sought to investigate SIA prevalence among Caucasian patients hospitalized with acute cerebral ischemia (ACI) in a prospective, multicenter Transcranial Doppler sonography (TCD) study. METHODS: Consecutive patients with ACI were prospectively evaluated with TCD over a 24-month-period. The previously validated criteria of SONIA trial were used for detection of >50{\%} intracranial stenosis with TCD. Brain angiography was performed to confirm the diagnosis in cases with abnormal TCD findings. SIA was diagnosed when there was evidence of a cerebral infarction in the territory of the stenotic artery (identified by TCD and confirmed by Magnetic resonance angiography [MRA]/Computed tomography angiography [CTA]). RESULTS: A total of 467 consecutive patients with ACI (60.4{\%} men, mean age 58 ± 14 years) were evaluated. SIA was documented in 43 patients (9.2{\%}; 95{\%}CI: 6.9{\%}-12.2{\%}). The most common SIA location was M1MCA (34.9{\%}) followed by TICA (18.8{\%}). Diabetes mellitus (OR: 4.25, 95{\%}CI: 2.18-8.26; P < .001) and hypertension (OR: 2.41, 95{\%}CI: 1.02-5.67; P = .045) were independently associated with SIA on multivariate models adjusting for potential confounders. CONCLUSIONS: SIA was identified in almost 10{\%} of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI.",
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T1 - Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians

T2 - A Prospective, Multicenter, Transcranial Doppler Study

AU - Tsivgoulis, Georgios

AU - Vadikolias, Konstantinos

AU - Heliopoulos, Ioannis

AU - Katsibari, Chaido

AU - Voumvourakis, Konstantinos

AU - Tsakaldimi, Soultana

AU - Boutati, Eleni

AU - Vasdekis, Spyros N.

AU - Athanasiadis, Dimitrios

AU - Al-Attas, Omar S.

AU - Charalampidis, Paris

AU - Stamboulis, Elefterios

AU - Piperidou, Charitomeni

PY - 2014/1/1

Y1 - 2014/1/1

N2 - BACKGROUND: There are limited data available regarding symptomatic intracranial atherosclerosis (SIA) prevalence in Caucasians. We sought to investigate SIA prevalence among Caucasian patients hospitalized with acute cerebral ischemia (ACI) in a prospective, multicenter Transcranial Doppler sonography (TCD) study. METHODS: Consecutive patients with ACI were prospectively evaluated with TCD over a 24-month-period. The previously validated criteria of SONIA trial were used for detection of >50% intracranial stenosis with TCD. Brain angiography was performed to confirm the diagnosis in cases with abnormal TCD findings. SIA was diagnosed when there was evidence of a cerebral infarction in the territory of the stenotic artery (identified by TCD and confirmed by Magnetic resonance angiography [MRA]/Computed tomography angiography [CTA]). RESULTS: A total of 467 consecutive patients with ACI (60.4% men, mean age 58 ± 14 years) were evaluated. SIA was documented in 43 patients (9.2%; 95%CI: 6.9%-12.2%). The most common SIA location was M1MCA (34.9%) followed by TICA (18.8%). Diabetes mellitus (OR: 4.25, 95%CI: 2.18-8.26; P < .001) and hypertension (OR: 2.41, 95%CI: 1.02-5.67; P = .045) were independently associated with SIA on multivariate models adjusting for potential confounders. CONCLUSIONS: SIA was identified in almost 10% of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI.

AB - BACKGROUND: There are limited data available regarding symptomatic intracranial atherosclerosis (SIA) prevalence in Caucasians. We sought to investigate SIA prevalence among Caucasian patients hospitalized with acute cerebral ischemia (ACI) in a prospective, multicenter Transcranial Doppler sonography (TCD) study. METHODS: Consecutive patients with ACI were prospectively evaluated with TCD over a 24-month-period. The previously validated criteria of SONIA trial were used for detection of >50% intracranial stenosis with TCD. Brain angiography was performed to confirm the diagnosis in cases with abnormal TCD findings. SIA was diagnosed when there was evidence of a cerebral infarction in the territory of the stenotic artery (identified by TCD and confirmed by Magnetic resonance angiography [MRA]/Computed tomography angiography [CTA]). RESULTS: A total of 467 consecutive patients with ACI (60.4% men, mean age 58 ± 14 years) were evaluated. SIA was documented in 43 patients (9.2%; 95%CI: 6.9%-12.2%). The most common SIA location was M1MCA (34.9%) followed by TICA (18.8%). Diabetes mellitus (OR: 4.25, 95%CI: 2.18-8.26; P < .001) and hypertension (OR: 2.41, 95%CI: 1.02-5.67; P = .045) were independently associated with SIA on multivariate models adjusting for potential confounders. CONCLUSIONS: SIA was identified in almost 10% of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI.

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