Association between Bilateral Vertebral Artery Blood Flow Changes and Posterior Circulation Infarction in Patients with Severe Intracranial Stenosis.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

Cerebrovascular Diseases Pub Date : 2024-08-19 DOI:10.1159/000540914

Xiaofeng Yuan, Yanhong Yan, Yan Zhang, Xinyi Cai, Pinjing Hui

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引用次数: 0

Abstract

Introduction: The objective of this study was to explore the association between net vertebral artery flow volume (NVAFV), calculated through color duplex ultrasonography, and posterior circulation infarction (PCI) in patients with severe intracranial vertebral artery (VA) stenosis.

Methods: 234 patients with severe intracranial VA stenosis (≥70%) were categorized into the PCI group (n = 139) and the non-PCI group (n = 95) based on cranial MRI diagnosis. The correlation between NVAFV and CT perfusion data was analyzed, and the occurrence of PCI under diverse PCI mechanisms was also investigated. Multifactorial logistic regression and stratified analysis was performed to analyze the association between NVAFV and PCI. Lastly, generalized additive models and smooth curve fitting was utilized to outline relationship between NVAFV and PCI.

Results: NVAFV showed a significant correlation with cerebral blood flow, mean transmit time, and time to peak. In the large artery atherosclerosis mechanism, a reduction in NVAFV correlated with a gradual rise in PCI cases (p = 0.002), while this trend lacked significance in the branch artery occlusive disease mechanism (p = 0.993). In the fully adjusted model, each 10 mL/min increase in NVAFV reduced PCI incidence by 11% (OR 0.890, 95% CI 0.840-0.943, p < 0.001), Sensitivity analysis showed similar results; NVAFV presented different PCI risks among various glucose level subgroups, the OR (95% CI) for PCI was 0.788 (0.684, 0.906) in low-glucose group (T1), 0.968 (0.878, 1.066) in moderate-glucose group (T2), and 0.886 (0.801, 0.979) in high-glucose group (T3). Smooth curve fitting demonstrated a linear negative association between NVAFV and PCI.

Conclusion: NVAFV demonstrated an association with PCI in patients with severe intracranial VA stenosis, it can serve as a reference for identifying high-risk populations of PCI; however, it must be considered in combination with glucose.

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严重颅内狭窄患者双侧椎动脉血流变化与后循环梗死之间的关系

导言目的：探讨通过彩色双相超声成像（CDU）计算的椎动脉净血流量（NVAFV）与颅内椎动脉（VA）严重狭窄患者后循环梗死（PCI）之间的关系。方法：根据头颅磁共振成像诊断结果，将 234 例颅内重度椎动脉狭窄（≥70%）患者分为 PCI 组（139 例）和非 PCI 组（95 例），分析 NVAFV 与 CT 灌注（CTP）数据的相关性，并探讨不同 PCI 机制下 PCI 的发生情况；采用多因素逻辑回归和分层分析法分析 NVAFV 与 PCI 的相关性。最后，利用广义加性模型和平滑曲线拟合勾勒出NVAFV与PCI之间的关系：NVAFV与脑血流量（CBF）、平均传输时间（MTT）和达峰时间（TTP）呈显著相关性；在大动脉粥样硬化机制中，NVAFV的降低与PCI病例的逐渐增加相关（P = 0.002），而在分支动脉闭塞性疾病机制中，这一趋势缺乏显著性（P = 0.993）；在完全调整模型中，NVAFV 每增加 10 毫升/分钟，PCI 发生率降低 11% （OR 0.890，95%CI 0.840 至 0.943，p <0.001），敏感性分析显示了类似的结果；NVAFV 在不同血糖水平亚组中呈现不同的 PCI 风险，PCI 的 OR（95%CI）为 0.低血糖组（T1）PCI OR 为 0.788 (0.684, 0.906)，中血糖组（T2）为 0.968 (0.878, 1.066)，高血糖组（T3）为 0.886 (0.801, 0.979)。平滑曲线拟合显示 NVAFV 与 PCI 之间呈线性负相关：结论：NVAFV与重度颅内VA狭窄患者的PCI有关，可作为识别PCI高危人群的参考，但必须与血糖结合考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.