Predictors of ischemic stroke recurrence in patients with symptomatic ICAS and contralateral high-grade stenosis

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-03-28 DOI:10.1016/j.clineuro.2025.108876

Zhicai Chen , YanYan Li , Weikang Chen , Pengshuai Liu , Jiajia Xiao , Hongwei Shi , Weiwen Qiu , Genlong Zhong

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引用次数: 0

Abstract

Objective

This study aims to identify predictive factors for the recurrence risk of ischemic stroke in patients with symptomatic ICAS and contralateral high-grade stenosis (sICAS-CHS).

Methods

We consecutively enrolled patients diagnosed with sICAS-CHS, which characterized by severe symptomatic intracranial artery stenosis (sICAS) alongside severe contralateral asymptomatic internal carotid artery or middle cerebral artery stenosis, confirmed by CT angiography (CTA). Over a one-year period, these patients were followed up to assess the recurrence risk of ischemic stroke. Binary logistic regression analysis was utilized to investigate the independent predictors of ipsilateral ischemic stroke recurrence within the territory of the symptomatic ICAS.

Results

The study included 80 patients with sICAS-CHS, comprising 56 males (70 %) with an average age of 69.44 ± 9.97 years. Over the one-year follow-up period, 16 patients (20 %) experienced recurrent ischemic strokes. Binary logistic regression analysis revealed that presence of watershed infarction (OR=6.002, p = 0.019), hyperhomocysteinemia (OR=4.469, p = 0.039), medication adherence (OR=0.207, p = 0.034), and endovascular therapy (OR=0.084, p = 0.029) were independent predictors of ischemic stroke recurrence in this cohort.

Conclusions

Patients with severe sICAS-CHS portended a considerable high recurrence risk of ischemic stroke. It is advisable to prioritize these individuals for endovascular therapy, particularly those who have suffered watershed infarctions.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.