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Kim BK, Kim B, You SH. Differentiation of Acute Internal Carotid Artery Occlusion Etiology on Computed Tomography Angiography: Diagnostic Tree for Preparing Endovascular Treatment. Diagnostics (Basel) 2024; 14:1524. [PMID: 39061661 PMCID: PMC11276486 DOI: 10.3390/diagnostics14141524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/08/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to identify the imaging characteristics and discriminate the etiology of acute internal carotid artery occlusion (ICAO) on computed tomography angiography (CTA) in patients with acute ischemic stroke. MATERIALS AND METHODS We retrospectively evaluated consecutive patients who underwent endovascular thrombectomy for acute ICAO. Contrast filling of the extracranial ICA in preprocedural CTA was considered apparent ICAO. Non-contrast filling of the extracranial ICA was evaluated according to the contrast-filled lumen configuration, lumen margin and location, Hounsfield units of the non-attenuating segment, and presence of calcification or an intimal flap. Digital subtraction angiography findings were the reference standard for ICAO etiology and the occlusion site. A diagnostic tree was derived using significant variables according to pseudo-occlusion, atherosclerotic vascular disease (ASVD), thrombotic occlusion, and dissection. RESULTS A total of 114 patients showed apparent ICAO (n = 21), pseudo-occlusion (n = 51), ASVD (n = 27), thrombotic occlusion (n = 9), or dissection (n = 6). Most pseudo-occlusions (50/51, 98.0%) showed dependent locations with ill-defined contrast column margins and classic flame or beak shapes. The most common occlusion site of pseudo-occlusion was the petro-cavernous ICA (n = 32, 62.7%). Apparent ICAO mainly appeared in cases with occlusion distal to the posterior communicating artery orifice. ASVD showed beak or blunt shapes in the presence of low-density plaques or dense calcifications. Dissection revealed flame- or beak-shaped appearances with circumscribed margins. Thrombotic occlusions tended to appear blunt-shaped. The decision-tree model showed a 92.5% overall accuracy. CONCLUSIONS CTA characteristics may help diagnose ICAO etiology. We provide a simple and easy decision-making model to inform endovascular thrombectomy.
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Affiliation(s)
| | - Byungjun Kim
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; (B.K.K.); (S.-H.Y.)
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Zhao TY, Xu GQ, Xue JY, Bai WX, Cai DY, Yang BW, Shi WY, Li TX, Gao BL. Significance of atherosclerotic plaque location in recanalizing non-acute long-segment occlusion of the internal carotid artery. Sci Rep 2024; 14:10945. [PMID: 38740919 DOI: 10.1038/s41598-024-61938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/11/2024] [Indexed: 05/16/2024] Open
Abstract
To investigate the significance of atherosclerotic plaque location in hybrid surgery comprising both endovascular recanalization approaches and carotid endarterectomy for symptomatic atherosclerotic non-acute long-segment occlusion of the internal carotid artery (ICA), 162 patients were enrolled, including 120 (74.1%) patients in the proximal plaque group and 42 (25.9%) in the distal plaque group. Surgical recanalization was performed in all patients, with successful recanalization in 119 (99.2%) patients in the proximal and 39 (92.9%) in the distal plaque group. The total successful recanalization rate was 97.5% (158/162) with a failure rate of 2.5% (4/162). Periprocedural complications occurred in 5 (4.2% or 5/120) patients in the proximal plaque group, including neck infection in two (1.7%), recurrent nerve injury in 1 (0.8%), and laryngeal edema in 2 (1.7%), and 2 (4.8%) in the distal plaque group, including femoral puncture infection in 2 (4.8%). No severe complications occurred in either group. Univariate analysis showed plaque location was a significant (P = 0.018) risk factor for successful recanalization, and multivariate analysis indicated that the plaque location remained a significant independent risk factor for recanalization success (P = 0.017). In follow-up 6-48 months after the recanalization surgery, reocclusion occurred in two (2.8%) patients in the proximal plaque group and 4 (13.3%) in the distal plaque group. In conclusion, although hybrid surgery achieves similar outcomes in patients with ICA occlusion caused by either proximal or distal atherosclerotic plaques, plaque location may be a significant risk factor for successful recanalization of symptomatic non-acute long-segment ICA occlusion.
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Affiliation(s)
- Tong-Yuan Zhao
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Gang-Qin Xu
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Jiang-Yu Xue
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Wei-Xing Bai
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Dong-Yang Cai
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Bo-Wen Yang
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Wei-Yu Shi
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Tian-Xiao Li
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
| | - Bu-Lang Gao
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
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Tang Y, Yang Y, Feng J, Geng Y, Wang Y, Wang R, Zhang D, Zhao J. Hybrid surgery can improve neurocognitive function in patients with internal carotid artery occlusion. Sci Rep 2023; 13:22793. [PMID: 38129543 PMCID: PMC10739823 DOI: 10.1038/s41598-023-50270-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Internal carotid artery occlusion (ICAO) is a relatively uncommon but important cause of transient ischaemic attack and cerebral infarction. Hybrid surgery (HS) improves cerebral perfusion, but its impact on neurocognitive function has been controversial. Patients with symptomatic chronic ICAO treated by hybrid surgery or medical treatment from 2016 to 2019 were included. We recorded and analysed the clinical characteristics, angiographic data, outcomes and cognitive status. Functional assessments, including the National Institutes of Health Stroke Scale (NIHSS), the Barthel Index, and a battery of neuropsychological tests, including the Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale-Cognitive Subtest (ADAS-cog), verbal fluency, and Colour Trail test Parts 1 and 2, were administered. Significant improvements in the ADAS (before, 7.5 ± 6.2 versus after, 5.2 ± 5.7; P = 0.022), MMSE (before, 25.5 ± 2.8 versus after, 28.1 ± 2.3; P = 0.013), and Colour Trail test Part 1 (before, 118.3 ± 26.5 versus after, 96.2 ± 23.1; P = 0.016) were observed six months after HS. Moreover, the abovementioned postprocedure scales were ameliorated in the HS group. This study found that in patients with multiple symptomatic ICAO and objective ipsilateral ischaemia, successful HS leads to improvement in the scores of three cognitive tests.
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Affiliation(s)
- Yudi Tang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yunna Yang
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
| | - Junqiang Feng
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yibo Geng
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yang Wang
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Rong Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong Zhang
- Department of Neurosurgery, Beijing Hospital, Beijing, China
| | - Jizong Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Kalita J, Show S, Biswas N, Datta A. Atherosclerosis risk assessment in human carotid artery with variation in sinus length: a numerical approach. Comput Methods Biomech Biomed Engin 2023:1-15. [PMID: 37950444 DOI: 10.1080/10255842.2023.2275546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
The mortality rates due to cardiovascular diseases are on a rise globally. One of the major cardiovascular diseases is stroke which occurs due to atherosclerotic plaques build-up in the carotid artery. The common carotid artery (CCA) bifurcates into the internal carotid artery (ICA) and external carotid artery (ECA). Sinus present at ICA is an ellipsoidal-shaped dilated region acting as a pressure receptor and blood flow regulator. Dimensions of the sinus vary from person to person, affecting the hemodynamics of the carotid artery. The current numerical study manifests a 3D flow analysis by varying the sinus length to investigate its local and global effects on the hemodynamics of the carotid artery using various biomechanical risk analysis parameters of atherosclerosis. User-defined function (UDF) dictates the pulsatile flow velocity profile imposed at the inlet. Near the outer wall (OW) of the sinus, the blood flow velocities are lower and recirculation zones are more. Though the recirculation zones for shorter sinus will be close to the inner wall (IW), interestingly, with an increase in the sinus length, the recirculation zones shift toward the OW with higher strength. These significantly decrease the x-wall shear stress (x-WSS) and time-averaged wall shear stress (TAWSS) values on the OW of the longer sinus. The other risk analysis parameters, like oscillatory shear index (OSI) and relative residence time (RRT), support the described consequences. These results reveal that sinus of increased length is more prone to developing atherosclerotic plaque.
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Affiliation(s)
- Jinmay Kalita
- Department of Mechanical Engineering, NIT Durgapur, Durgapur, India
| | - Subham Show
- Department of Mechanical Engineering, NIT Durgapur, Durgapur, India
| | - Nirmalendu Biswas
- Department of Power Engineering, Jadavpur University, Kolkata, India
| | - Aparesh Datta
- Department of Mechanical Engineering, NIT Durgapur, Durgapur, India
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Ren W, Xue J, Zhao T, Xu G, Yang B, Li T, Gao B. Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery. Sci Rep 2023; 13:17026. [PMID: 37813974 PMCID: PMC10562445 DOI: 10.1038/s41598-023-44406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/07/2023] [Indexed: 10/11/2023] Open
Abstract
To investigate the effect of endovascular and/or hybrid surgical recanalization on chronic long-segment occlusion of the internal carotid artery (ICA) and the effect of occlusion location on the recanalization rate and prognosis, 87 patients with chronic ICA occlusion treated with endovascular approach only or hybrid surgery were retrospectively enrolled. The duration of ICA occlusion ranged from 21 to 360 days (median 30). Type I occlusion (from the neck to below the cavernous segment) consisted of 46 (52.8%) patients while type II (from the neck to above the clinoid segment) of 41 (47.1%). Hybrid surgery was performed in 44 (50.6%) patients while endovascular recanalization only was conducted in the other 43 (49.4%). In all patients, the success rate of recanalization was 93.0% (40/43) for the endovascular approach and 95.5% for the hybrid surgical approach. In patients with type I occlusion, endovascular recanalization only was performed in 22 (47.8%) patients and hybrid surgery in 24 (52.2%), resulting in successful recanalization in all patients (100%). In patients with type II occlusion, the success rate of recanalization was 85.7% (18/21) for the endovascular approach only but 90% (18/20) for the hybrid surgery. The total success rate of recanalization was 94.3% (82/87) for all patients, 100% for type I occlusion, and 87.8% for type II occlusion. No significant (P = 0.12) differences existed in the recanalization rate between groups I and II. Clinical follow-up was performed in 82 (94.3%) patients 6-39 months (mean 16) after the surgery. Re-occlusion occurred in 0 in group I but in four (9.8%) in group II. The mRS was good with 0-2 in 38 (82.6%) patients in group I and in 27 (75%) patients in group II, with no significant (P = 0.78) difference. In conclusion, chronic long-segment ICA occlusion can be safely and efficiently recanalized with the endovascular and hybrid surgery. The location of ICA occlusion may have a critical role in determining the recanalization rate, and careful evaluation of the occlusion location may be helpful in increasing the prognosis of recanalization.
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Affiliation(s)
- Wei Ren
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Jiangyu Xue
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Tongyuan Zhao
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Gangqin Xu
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Bowen Yang
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Tianxiao Li
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China.
| | - Bulang Gao
- Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450000, Henan, China.
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Zhang B, Wang G, Gao Y, Tan H, Wang P. Influence of the integrity of circle of Willis on asymptomatic or mild patients with first diagnosed chronic internal carotid artery occlusion. Eur J Radiol 2023; 165:110954. [PMID: 37406584 DOI: 10.1016/j.ejrad.2023.110954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/08/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND In order to identify individuals with chronic internal carotid artery occlusion (CICAO), it is essential to understand the integrity of the circle of Willis (CoW). This understanding is important as it may determine the potential benefits of active medical and endovascular treatments. PURPOSE The objective of this study is to assess whether diminished integrity of the CoW can serve as a useful marker for identifying individuals with more severe impairment in cerebral blood perfusion and a higher incidence of cerebral infarction among asymptomatic or mildly affected patients with CICAO. MATERIALS AND METHODS We conducted a retrospective review of asymptomatic or mildly affected patients with newly diagnosed CICAO who did not receive reperfusion therapies. The categorization of patients into good or poor integrity groups was based on the assessment of CoW integrity using CTA. We evaluated the volume and value of prolonged time to peak (TTP) in both groups, as well as the occurrence of new cerebral infarctions. Our analysis involved multivariate regression and receiver operating characteristic (ROC) analysis. RESULTS Hemodynamic abnormalities characterized by prolonged TTP were observed in the affected side's blood supply region in all 38 patients. There was a notable difference in the volume and value of prolonged TTP between the two groups (P < 0.001). Correlation analyses based on CTP and CTA parameters revealed a negative relationship between CoW scores and both the abnormal volume (r = -0.624, P = 0.000) and value (r = -0.589, P = 0.000) of prolonged TTP. Upon multivariable adjustment, the independent predictors for new cerebral infarction and higher volume of prolonged TTP were solely the CoW status, with respective estimates of (b = 6.05; 95% confidence interval [CI]: 1.619, 22.619; P = 0.007) and (b = 35.486; 95% CI: 4.697, 268.088; P = 0.001). CONCLUSION Assessing the integrity of the CoW is crucial in evaluating abnormal perfusion in asymptomatic or mildly affected individuals who are newly diagnosed with CICAO and have not undergone reperfusion therapy.
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Affiliation(s)
- Bo Zhang
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Shanghai, China No. 389, Xincun Road, Shanghai 200065, China
| | - Guanliansheng Wang
- Department of Medical Imaging, Shanghai TCM-integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China No. 230, Baoding Road, Shanghai 200082, China
| | - Yan Gao
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Shanghai, China No. 389, Xincun Road, Shanghai 200065, China
| | - Huaqiao Tan
- Department of Intervention Department, Tongji Hospital, Tongji University School of Medicine, Shanghai, China No. 389, Xincun Road, Shanghai 200065, China
| | - Peijun Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Shanghai, China No. 389, Xincun Road, Shanghai 200065, China.
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Morphological and Compositional Features of Chronic Internal Carotid Artery Occlusion in MR Vessel Wall Imaging Predict Successful Endovascular Recanalization. Diagnostics (Basel) 2023; 13:diagnostics13010147. [PMID: 36611438 PMCID: PMC9818158 DOI: 10.3390/diagnostics13010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Background: We sought to determine if the morphological and compositional features of chronic internal carotid artery occlusion (CICAO), as assessed by MR vessel wall imaging (MR-VWI), initially predict successful endovascular recanalization. Methods: Consecutive patients with CICAO scheduled for endovascular recanalization were recruited. MR-VWI was performed within 1 week prior to surgery for evaluating the following features: proximal stump morphology, extent of occlusion, occlusion with collapse, arterial tortuosity, the presence of hyperintense signals (HIS) and calcification in the occluded C1 segment. Multivariate logistic regression was used to identify features associated with technical success and construct a prediction model. Results: Eighty-three patients were recruited, of which fifty-seven (68.7%) were recanalized successfully. The morphological and compositional characteristics of CICAO were associated with successful recanalization, including occlusions limited to C1 and extensive HIS, as well as the absence of extensive calcification, absence of high tortuosity, and absence of artery collapse. The MR CICAO score that comprised the five predictors showed a high predictive ability (area under the curve: 0.888, p < 0.001). Conclusion: the MR-VWI characteristics of CICAO predicted the technical success of endovascular recanalization and may be leveraged for identifying patients with a high probability of successful recanalization.
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Wu J, Fang C, Wei L, Liu Y, Xu H, Wang X, Yuan L, Wu X, Xu Y, Zhang A. Spotlight on clinical strategies of Chronic Internal Carotid Artery Occlusion: Endovascular interventions and external-intracarotid bypasses compared to conservative treatment. Front Surg 2022; 9:971066. [PMID: 36425889 PMCID: PMC9679017 DOI: 10.3389/fsurg.2022.971066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/18/2022] [Indexed: 10/11/2023] Open
Abstract
Chronic internal carotid artery occlusion (CICAO) has high prevalence and incidence rates, and patients with CICAO can be completely asymptomatic, experience a devastating stroke or die. It is important to note that CICAO causes cerebrovascular accidents. Currently, the external carotid-internal carotid (EC-IC) bypass technique is used to treat CICAO. However, many clinical studies showed that EC-IC bypass was not beneficial for many patients with CICAO. Meanwhile, endovascular intervention treatment options for CICAO are evolving, and an increasing number of patients are undergoing endovascular intervention therapy. Accordingly, a review comparing both techniques is warranted. For this review, we searched PubMed and collected relevant case study reports comparing endovascular interventional therapy and internal and external cervical bypass surgeries to provide strategies for clinical treatment.
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Affiliation(s)
- Junnan Wu
- Department of Emergency, Dongyang Hospital Affiliated to Wenzhou Medical University, Jinhua, China
| | - Chaoyou Fang
- Department of Neurosurgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lingying Wei
- Department of Emergency, Dongyang Hospital Affiliated to Wenzhou Medical University, Jinhua, China
| | - Yibo Liu
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Shanghai, China
- Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China
| | - Houshi Xu
- Department of Neurosurgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyu Wang
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Shanghai, China
- Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China
| | - Ling Yuan
- Department of Neurosurgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoya Wu
- Department of Emergency, Dongyang Hospital Affiliated to Wenzhou Medical University, Jinhua, China
| | - Yuanzhi Xu
- Department of Neurosurgery, Huashan Hospital, School of Medicine, Fudan University, Shanghai, China
| | - Anke Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Shanghai, China
- Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China
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Qiu Z, Guo T, Sheng X, Tang Y, Du H. Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients with Chronic Internal Carotid Artery Occlusion Complicated by Cerebral Infarction. Neuropsychiatr Dis Treat 2022; 18:2265-2271. [PMID: 36268267 PMCID: PMC9578499 DOI: 10.2147/ndt.s384512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/08/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study aims to investigate the prognostic value of the peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with chronic internal carotid artery occlusion (CICAO) complicated by cerebral infarction. PATIENTS AND METHODS The clinical data of 99 CICAO patients complicated by cerebral infarction were retrospectively analyzed. The modified Rankin Scale (mRS) was used to assess their 3-month prognosis, and a multivariate logistic regression model was established to explore risk factors for poor prognosis. RESULTS Multivariate logistic regression analysis demonstrated that NLR (OR=2.114; 95% CI: 1.129-3.959) and baseline National Institute of Health Stroke Scale (NIHSS; OR=1.288, 95% CI: 1.053-1.574) score were risk factors of poor prognosis. The area under the receiver operator characteristic (ROC) curve of NLR in predicting the 3-month outcome after onset was 0.717 (95% CI: 0.606-0.828, P<0.000). The optimal cut-off value was 3.22, with a sensitivity of 0.743 and a specificity of 0.791. CONCLUSION NLR is an independent risk factor for the poor prognosis of CICAO patients complicated by cerebral infarction and can serve as an indicator for clinical prognosis.
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Affiliation(s)
- Zhuoyin Qiu
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Tingting Guo
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Xihua Sheng
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Ying Tang
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Huaping Du
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
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