Pattern of intracranial versus extracranial atherosclerotic cerebrovascular disease in indian patients with stroke: An angiography study


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Article type :

Original Article

Author :

Atulabh Vajpeyee, Shivam Tiwari, Lokendra Bahadur Yadav, Saurabh Gupta, Manisha Vajpeyee

Volume :

6

Issue :

3

Abstract :

Background: The atherosclerotic stenotic disease forms an important cause of secondary prevention of stroke. In the recent past with the availability of various imaging modalities and cerebral digital subtraction angiography (DSA) for the evaluation of stroke patients, the number of atherosclerotic stenotic diseases is at rising. This study analyses retrospectively and prospectively angiographic data in ischemic stroke patients referred to our center, which is a territory care hospital. Materials and Methods: Between January 2016 to March 2019, 224 cerebral DSA was performed in the patients referred to us in university medical college, who had small or large vessel disease diagnosed by Doppler, CTA, or MRA. The degrees of stenosis of bilateral cervical carotid arteries, vertebrobasilar system, and their major intracranial branches were recorded. Lesions were described as being single or multiple according to the number of lesions. Results: Of the total 1024 patients, 224 patients were enrolled in the study, 54 were females. The mean age was 54years. A total of 404 lesions were present in 224 patients. Amongthese patients, single lesions were found in 64 (15.8%) and multiplelesions in 340 (84.15%). Of the single lesion, 40 were extracranial and 14 were intracranial stenosis. Out of 340 multiple lesions 88 (25.88%) were intracranial, 186(57.70%) extracranial, and combined in 66(19.41%). Lesions were located in the anterior circulation in 132 patients(58.9%) and the posterior circulation 62 patients (27.67%) and at the combined location in 30 patients (13.39%). Conclusion: This study is the first report from the Indian subcontinent depicting a higher incidence of intracranial stenosis based on angiography. The reason for relatively higher incidence could be shared geographical region (Asia) in concordance with Chinese and Korean studies but relatively lower incidence from this population may be due to different prevalence of risk factors in this population.

Keyword :

 Angiography, Multiple lesions, Single lesions, Atherosclerotic stenotic disease.
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