Intracranial versus Extracranial Symptomatic Carotid Atherosclerosis in Chinese Patients: Risk Factors, Stroke Mechanisms, and Long-Term Prognosis

This study aims to investigate the clinical-radiological features and stroke mechanisms of symptomatic intracranial internal carotid artery (IICA) atherosclerosis and prognoses of patients with IICA atherosclosis, and compare these data with those from patients with symptomatic extranial carotid artery (EICA) atherosclerosis. We prospectively recruited 155 patients with symptomatic IICA or EICA atherosclerosis (stenosis ≥50% or occlusion) from 1968 Chinese patients with a first-ever ischemic stroke or transient ischemic attack. The patients were followed up for stroke recurrence, cardiovascular events, and death. There were 80 and 75 patients in the IICA and EICA groups, respectively. Multivariate logistic regression analyses showed that the patients in the IICA group were associated with hypertension (odds ratio [OR], 5.980; 95% confidence interval [CI], 1.790-19.976) and asymptomatic intracranial atherosclerosis (OR, 2.564; 95% CI, 1.222-5.377), while the patients in the EICA group were associated with smoking (OR, 2.397; 95% CI, 1.150-4.998) and contralateral EICA disease (OR, 4.742; 95% CI, 1.455-15.455). Hemodynamic stroke alone was more common in the IICA group; artery-to-artery embolism was identified more often in the E...Continue Reading