Ophthalmic artery flow direction change predicts recurrence of ischemic stroke after carotid stenting: a longitudinal observational study

European Journal of Medical Research

Research

Chih-Ming Lin¹  Hui-Yi Yang²  Chi-Kuang Liu³  Shih-Chun Wang⁴  Yang-Hao Ou⁵  Ie-Bin Lian⁶  Ta-Tsung Lin⁷ 

[1] Department of Mathematics, National Changhua University of Education, Changhua City, Taiwan;Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua City, Taiwan;Department of Neurology, Changhua Christian Hospital, 135 Nanhsiao Street Changhua City 50006, Changhua City, Taiwan;Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, Taiwan;Department of Social Work and Child Welfare, Providence University, Taichung City, Taiwan;Department of Mathematics, National Changhua University of Education, Changhua City, Taiwan;Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan;Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan;Department of Medicine Imaging, Changhua Christian Hospital, Changhua City, Taiwan;Department of Neurology, Changhua Christian Hospital, 135 Nanhsiao Street Changhua City 50006, Changhua City, Taiwan;Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua City, Taiwan;Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua City, Taiwan;

关键词: Carotid stent;    Change of ophthalmic artery flow;    Ischemic stroke;    Carotid duplex;    Magnetic resonance angiography;    Middle cerebral artery;   

DOI  :  10.1186/s40001-022-00965-9

 received in 2022-08-19, accepted in 2022-12-20,  发布年份 2022

来源: Springer

【 摘 要 】

Background and purposeThe implantation of carotid artery stents prevents recurrent ischemic stroke in patients with carotid stenosis. This study aimed to investigate associations between change of ophthalmic artery flow (COAF) post carotid stenting and recurrent ischemic stroke, as well as the link toward the anterior and posterior circulations and patients’ prognosis after carotid stenting.MethodsThis retrospective, longitudinal cohort study recruited 87 left side carotid stenosed ischemic stroke patients undergoing left side carotid stenting between year of 2009 and 2013, and patients were followed up to 9 years after carotid procedures. Clinical data were derived from medical records. The primary outcome was stroke recurrence. Predictive factors were stenosis  > 50% in one intracranial artery and ROAF. Kaplan–Meier and Cox regression analyses were used to identify risk factors associated with stroke recurrence.ResultsAmong 87 included patients undergone left side carotid stent treatment, 44 had stroke recurrence within 3 years after carotid stenting. The recurrence group had significantly greater proportions of COAF after stenting (p = 0.001), and middle cerebral artery (MCA) and basilar artery or vertebral artery (BA/VA) stenosis > 50% (all p < 0.001) than the no-recurrence group. Survival was significantly shorter in patients with COAF than in those without (p < 0.01). Regression analysis showed that COAF was associated with stroke recurrence (HR: 3.638, 95% CI 1.54–8.62, p = 0.003). The recurrence rate was highest in patients with bilateral MCA stenosis  > 50% (100%), followed by left MCA stenosis  > 50% plus BA/VA stenosis  > 50% (83.33%) or COAF (82.14%). Patients with bilateral MCA stenosis  < 50% had no recurrence within 3-year follow-up.ConclusionsPrognosis after carotid stenting is poorer for patients with MCA stenosis  > 50%, BA/VA stenosis  > 50% and/or COAF. Carotid duplex and magnetic resonance angiography provide definitive information for prognosis prediction.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

41116_2022_35_Article_IEq307.gif

41116_2022_35_Article_IEq305.gif

41116_2022_35_Article_IEq303.gif

41116_2022_35_Article_IEq301.gif

41116_2022_35_Article_IEq299.gif