Multiple intracranial arterial stenosis influences the long-term prognosis of symptomatic middle cerebral artery occlusion.
BACKGROUND
Large intracranial occlusive vascular disease is a major contributor to the incidence of stroke worldwide, especially when it involves the middle cerebral artery (MCA). The data on the prognosis of symptomatic atherosclerotic MCA occlusions (MCAO) with concomitant intracranial arterial disease (MCAO-AIS) are limited. MCAO-AIS may reflect the extent of the atherosclerotic intracranial disease, we hypotheses that coexisting intracranial arterial disease influenced the prognosis of MCAO.


METHODS
Patients having survived at least one month after the initial ischemic stroke who suffered from atherosclerotic occlusion of the MCA were enrolled. According to their concomitant atherosclerotic intracranial arterial disease, the patients were assigned to one of two groups: the MCAO or the MCAO-AIS. All of the patients' cerebrovascular risk factors were recorded. Recurrent ischemic stroke and death were the end-point events during the follow-up.


RESULTS
A total of 232 patients (mean age 57.68 ± 9.50 years; 69% male) were analyzed. The mean follow-up time was 17.65 months. The end-point events occurred in 35 (15.09%) patients, resulting in an annual rate of 10.26%. The presence of MCAO- AIS was an independent risk factor associated with the patient's prognosis in the cohort (OR = 3.426, 95% CI 1.261 to 9.308; p = 0.016), as well as gender and diabetes mellitus. The MCAO-AIS were more likely to experience ipsilateral ischemic strokes, but the difference was not statistically significant.


CONCLUSIONS
Concomitant intracranial arterial disease may influence the prognosis of patients with atherosclerotic MCAO. The result warrants further research in larger sample population.
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China. lltian28@gmail.com.|Department of Neurology, The People's Hospital of Fuyang City, 63 Luci Road, Fuyang, 236010, Anhui Province, China. lltian28@gmail.com.
Lili
L
Tian
Department of Neurology, Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China. yuexy2002@hotmail.com.
Xuanye
X
Yue
Department of Neurology, Shanghai Clinical Center, Chinese Academy of Sciences/Shanghai Xuhui Central Hospital, 966 Middle Huaihai, Shanghai, 200030, China. xgmsys@163.com.
Gangming
G
Xi
Department of Neurology, The People's Hospital of Fuyang City, 63 Luci Road, Fuyang, 236010, Anhui Province, China. fyswym@163.com.
Youmeng
Y
Wang
Department of Neurology, The People's Hospital of Fuyang City, 63 Luci Road, Fuyang, 236010, Anhui Province, China. fyszy1@163.com.
Zongyou
Z
Li
Department of Neurology, The People's Hospital of Fuyang City, 63 Luci Road, Fuyang, 236010, Anhui Province, China. fysyyzy@163.com.
Ying
Y
Zhou
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China. xfliu2@vip.163.com.
Xiaobing
X
Fan
D000368:Aged; D003251:Constriction, Pathologic / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000453:epidemiology*; D020765:Intracranial Arterial Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*