title: Intracranial Carotid Artery Calcification Relates to Recanalization and Clinical Outcome After Mechanical Thrombectomy.
abstract: Intracranial carotid artery calcification (ICAC) is a surrogate marker of intracranial arteriosclerosis, which may impact the revascularization and clinical outcome of acute stroke patients who undergo mechanical thrombectomy.
  
  
  
  We included 194 patients admitted to our Stroke Unit between January 2009 and September 2015 who underwent mechanical thrombectomy for an anterior circulation occlusion. ICAC was quantified in both intracranial carotid arteries on the nonenhanced computed tomographic scan that was acquired before thrombectomy. Complete arterial revascularization was defined as a Thrombolysis in Cerebral Infarction ≥2b on the final angiographic examination. Poor functional outcome was defined as a modified Rankin Scale score of >2 at 90 days. We assessed the independent effect of ICAC volume on complete arterial revascularization, functional outcome, and mortality using logistic regression models adjusted for relevant confounders.
  
  
  
  ICAC was present in 164 (84.5%) patients, with a median volume of 87.1 mm3(25th-75th quartile: 18.9-254.6 mm3). We found that larger ICAC volumes were associated with incomplete arterial revascularization (adjusted odds ratio per unit increase in ln-transformed ICAC volume 0.73 [95% confidence interval, 0.57-0.93]) and with poorer functional outcome (adjusted odds ratio per unit increase in ln-transformed ICAC volume 1.31 [95% confidence interval, 1.04-1.66]).
  
  
  
  A larger amount of ICAC before mechanical thrombectomy in acute stroke patients is an indicator of worse postprocedural arterial revascularization and poorer functional outcome.
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: María
authors.initials: M
authors.lastname: Hernández-Pérez
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Bos
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Laura
authors.initials: L
authors.lastname: Dorado
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Karlijn
authors.initials: K
authors.lastname: Pellikaan
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Elena
authors.initials: E
authors.lastname: López-Cancio
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Natalia
authors.initials: N
authors.lastname: Pérez de la Ossa
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Meritxell
authors.initials: M
authors.lastname: Gomis
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Carlos
authors.initials: C
authors.lastname: Castaño
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Josep
authors.initials: J
authors.lastname: Munuera
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Josep
authors.initials: J
authors.lastname: Puig
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.).
authors.forename: Mònica
authors.initials: M
authors.lastname: Millán
authors.affiliation: From the Acute Stroke Unit, Department of Neurosciences (M.H.-P., L.D., E.L.-C., N.P.d.l.O., M.G., M.M., A.D.), Interventional Neuroradiology Unit, Department of Neurosciences (C.C.), and Diagnostic Imaging Institute (J.M.), Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain; Department of Radiology and Nuclear Medicine (D.B., K.P., M.W.V.) and Department of Epidemiology (D.B., M.W.V.), Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (D.B.); and Department of Radiology, IDIBGI Diagnostic Imaging Institute, Dr. Josep Trueta University Hospital, Girona, Spain (J.P.). adavalos.germanstrias@gencat.cat.
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002548:Cerebral Revascularization / Q000401:mortality* / Q000639:trends; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D008297:Male; D061185:Mechanical Thrombolysis / Q000401:mortality* / Q000639:trends; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy
keywords: aged; angiography; intracranial arteriosclerosis; prognosis; stroke