Abstract
Introduction
Intracranial internal carotid artery calcifications (ICAC), a frequent finding on imaging studies, are predictive of future stroke risk in population-based studies. The clinical significance of this observation among ischemic stroke patients is however less clear. In this study, we analyzed ICAC burden in relation to vascular risk factor profile, stroke etiology, and extent of craniocervical vascular calcifications in a consecutive series of ischemic stroke patients.
Methods
The burden of ICAC was determined both on non-contrast CT and CT-angiography source images by semiquantitative scoring algorithms. The distribution of vascular risk factors, etiologic stroke subtype, and calcification burden in other craniocervical arteries was assessed among patients with no ICAC, mild–moderate ICAC, and severe ICAC.
Results
Of 319 patients included into the study, 28 % had no ICAC, 35 % had mild–moderate ICAC, and 37 % had severe ICAC on CT angiography. Independent factors associated with ICAC burden in multivariate analysis included age (p < 0.001), diabetes mellitus (p = 0.006), and coronary artery disease (p < 0.001). Furthermore, a stroke etiology of large artery atherosclerosis or cardioaortic embolism was significantly related to higher ICAC burden (p = 0.006). Patients with severe ICAC were more likely to harbor calcifications in other vascular beds (p < 0.001). All of these findings persisted when analyses were repeated with CT-based ICAC burden assessments.
Conclusion
ICAC burden reflects a continuum of atherosclerotic disease involving carotid arteries together with other craniocervical vascular beds. ICAC is significantly associated with stroke of large vessel or cardioembolic origin. This information might help the clinician in prioritizing etiologic work-up in the acute period.
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Ethical standards and patient consent
We declare that all human and animal studies have been approved by the Hacettepe University Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that due to the retrospective design of the study, patient consent was waived.
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We declare that we have no conflict of interest.
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Yilmaz, A., Akpinar, E., Topcuoglu, M.A. et al. Clinical and imaging features associated with intracranial internal carotid artery calcifications in patients with ischemic stroke. Neuroradiology 57, 501–506 (2015). https://doi.org/10.1007/s00234-015-1494-8
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DOI: https://doi.org/10.1007/s00234-015-1494-8