Association of Left Vertebral Artery Hypoplasia with Posterior Circulation Stroke and the Functional Outcome of Patients with Atrial Fibrillation-Related Cardioembolic Stroke
A cardiogenic embolus could reach the posterior circulation through the right vertebral artery because of a relatively larger diameter in cases of left vertebral artery hypoplasia. Hence, we investigated whether left vertebral artery hypoplasia is associated with cardiac embolisms with atrial fibril...
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2023-01, Vol.44 (1), p.65-69 |
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| creator | Bae, J-H Ryu, J-C Ha, S H Kim, B J Kang, D-W Kwon, S U Kim, J-S Chang, J Y |
| description | A cardiogenic embolus could reach the posterior circulation through the right vertebral artery because of a relatively larger diameter in cases of left vertebral artery hypoplasia. Hence, we investigated whether left vertebral artery hypoplasia is associated with cardiac embolisms with atrial fibrillation in the posterior circulation and its functional outcomes.
In this monocentric retrospective study, patients with acute cardioembolic stroke with atrial fibrillation were enrolled and underwent CT or neck MRA, which visualized the aortic arch and subclavian arteries. The laterality and size of vertebral artery hypoplasia were recorded. Posterior circulation stroke, basilar artery occlusion, and the functional outcomes after 3 months were investigated.
This study included 407 patients; the patients with left vertebral artery hypoplasia experienced a higher rate of posterior circulation stroke (19 versus 73; 42.2% versus 20.2%;
= .001) and basilar artery occlusion (5 versus 10; 11.1% versus 2.8%;
= .005) than the patients without left vertebral artery hypoplasia. Multivariate analysis revealed that left vertebral artery hypoplasia showed an association with lower odds of achieving a good functional outcome 3 months after the stroke (OR = 0.4; 95% CI, 0.2-0.9;
= .027).
Patients with cardioembolic stroke and left vertebral artery hypoplasia had posterior circulation stroke, basilar artery occlusion, and poor functional outcomes after 3 months. |
| doi_str_mv | 10.3174/ajnr.A7738 |
| format | Article |
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In this monocentric retrospective study, patients with acute cardioembolic stroke with atrial fibrillation were enrolled and underwent CT or neck MRA, which visualized the aortic arch and subclavian arteries. The laterality and size of vertebral artery hypoplasia were recorded. Posterior circulation stroke, basilar artery occlusion, and the functional outcomes after 3 months were investigated.
This study included 407 patients; the patients with left vertebral artery hypoplasia experienced a higher rate of posterior circulation stroke (19 versus 73; 42.2% versus 20.2%;
= .001) and basilar artery occlusion (5 versus 10; 11.1% versus 2.8%;
= .005) than the patients without left vertebral artery hypoplasia. Multivariate analysis revealed that left vertebral artery hypoplasia showed an association with lower odds of achieving a good functional outcome 3 months after the stroke (OR = 0.4; 95% CI, 0.2-0.9;
= .027).
Patients with cardioembolic stroke and left vertebral artery hypoplasia had posterior circulation stroke, basilar artery occlusion, and poor functional outcomes after 3 months.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.A7738</identifier><identifier>PMID: 36521964</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Aorta, Thoracic ; Arterial Occlusive Diseases - complications ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnostic imaging ; Embolic Stroke - complications ; Extracranial Vascular ; Humans ; Retrospective Studies ; Stroke - complications ; Stroke - diagnostic imaging ; Vertebral Artery - diagnostic imaging ; Vertebrobasilar Insufficiency - complications ; Vertebrobasilar Insufficiency - diagnostic imaging</subject><ispartof>American journal of neuroradiology : AJNR, 2023-01, Vol.44 (1), p.65-69</ispartof><rights>2023 by American Journal of Neuroradiology.</rights><rights>2023 by American Journal of Neuroradiology 2023 American Journal of Neuroradiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-20fdb5f6f540785b07271f9427755ebde5f2111b8b5a6476ce2788b76498463c3</citedby><cites>FETCH-LOGICAL-c378t-20fdb5f6f540785b07271f9427755ebde5f2111b8b5a6476ce2788b76498463c3</cites><orcidid>0000-0003-4880-9258 ; 0000-0002-3278-3252 ; 0000-0002-2999-485X ; 0000-0002-2926-2368 ; 0000-0002-0935-963X ; 0000-0002-1538-6642</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835927/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835927/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36521964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bae, J-H</creatorcontrib><creatorcontrib>Ryu, J-C</creatorcontrib><creatorcontrib>Ha, S H</creatorcontrib><creatorcontrib>Kim, B J</creatorcontrib><creatorcontrib>Kang, D-W</creatorcontrib><creatorcontrib>Kwon, S U</creatorcontrib><creatorcontrib>Kim, J-S</creatorcontrib><creatorcontrib>Chang, J Y</creatorcontrib><title>Association of Left Vertebral Artery Hypoplasia with Posterior Circulation Stroke and the Functional Outcome of Patients with Atrial Fibrillation-Related Cardioembolic Stroke</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>A cardiogenic embolus could reach the posterior circulation through the right vertebral artery because of a relatively larger diameter in cases of left vertebral artery hypoplasia. Hence, we investigated whether left vertebral artery hypoplasia is associated with cardiac embolisms with atrial fibrillation in the posterior circulation and its functional outcomes.
In this monocentric retrospective study, patients with acute cardioembolic stroke with atrial fibrillation were enrolled and underwent CT or neck MRA, which visualized the aortic arch and subclavian arteries. The laterality and size of vertebral artery hypoplasia were recorded. Posterior circulation stroke, basilar artery occlusion, and the functional outcomes after 3 months were investigated.
This study included 407 patients; the patients with left vertebral artery hypoplasia experienced a higher rate of posterior circulation stroke (19 versus 73; 42.2% versus 20.2%;
= .001) and basilar artery occlusion (5 versus 10; 11.1% versus 2.8%;
= .005) than the patients without left vertebral artery hypoplasia. Multivariate analysis revealed that left vertebral artery hypoplasia showed an association with lower odds of achieving a good functional outcome 3 months after the stroke (OR = 0.4; 95% CI, 0.2-0.9;
= .027).
Patients with cardioembolic stroke and left vertebral artery hypoplasia had posterior circulation stroke, basilar artery occlusion, and poor functional outcomes after 3 months.</description><subject>Aorta, Thoracic</subject><subject>Arterial Occlusive Diseases - complications</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Embolic Stroke - complications</subject><subject>Extracranial Vascular</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>Stroke - complications</subject><subject>Stroke - diagnostic imaging</subject><subject>Vertebral Artery - diagnostic imaging</subject><subject>Vertebrobasilar Insufficiency - complications</subject><subject>Vertebrobasilar Insufficiency - diagnostic imaging</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkd-O1CAUxonRuLOrNz6A4dKYdAVaSrkxaSbOrskku_FfvCNATx3WtswC1cxL-YwydtzoFSfnfPzOBx9CLyi5LKmo3ui7KVy2QpTNI7SisqwLyeXXx2hFqORFTUlzhs5jvCOEcCnYU3RW1pxRWVcr9KuN0Vunk_MT9j3eQp_wFwgJTNADbnMRDvj6sPf7QUen8U-XdvjWx9x3PuC1C3YelusfU_DfAeupw2kHeDNP9tjPmJs5WT_CccFt1sKU4gJqU3B5vnEmuGHBFB8gF9DhtQ6d8zAaPzh7gj9DT3o9RHh-Oi_Q5827T-vrYntz9X7dbgtbiiYVjPSd4X3d84qIhhsimKC9rJgQnIPpgPeMUmoaw3VdidoCE01jRF3JpqpLW16gtwt3P5sROpsd5-9Q--BGHQ7Ka6f-n0xup775H0o2JZdMZMCrEyD4-xliUqOLFvIbJ_BzVCwb4YJXnGTp60Vqg48xQP-whhJ1DFgdA1Z_As7il_8ae5D-TbT8Dd8rpsw</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Bae, J-H</creator><creator>Ryu, J-C</creator><creator>Ha, S H</creator><creator>Kim, B J</creator><creator>Kang, D-W</creator><creator>Kwon, S U</creator><creator>Kim, J-S</creator><creator>Chang, J Y</creator><general>American Society of Neuroradiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4880-9258</orcidid><orcidid>https://orcid.org/0000-0002-3278-3252</orcidid><orcidid>https://orcid.org/0000-0002-2999-485X</orcidid><orcidid>https://orcid.org/0000-0002-2926-2368</orcidid><orcidid>https://orcid.org/0000-0002-0935-963X</orcidid><orcidid>https://orcid.org/0000-0002-1538-6642</orcidid></search><sort><creationdate>202301</creationdate><title>Association of Left Vertebral Artery Hypoplasia with Posterior Circulation Stroke and the Functional Outcome of Patients with Atrial Fibrillation-Related Cardioembolic Stroke</title><author>Bae, J-H ; Ryu, J-C ; Ha, S H ; Kim, B J ; Kang, D-W ; Kwon, S U ; Kim, J-S ; Chang, J Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-20fdb5f6f540785b07271f9427755ebde5f2111b8b5a6476ce2788b76498463c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aorta, Thoracic</topic><topic>Arterial Occlusive Diseases - complications</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Embolic Stroke - complications</topic><topic>Extracranial Vascular</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>Stroke - complications</topic><topic>Stroke - diagnostic imaging</topic><topic>Vertebral Artery - diagnostic imaging</topic><topic>Vertebrobasilar Insufficiency - complications</topic><topic>Vertebrobasilar Insufficiency - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bae, J-H</creatorcontrib><creatorcontrib>Ryu, J-C</creatorcontrib><creatorcontrib>Ha, S H</creatorcontrib><creatorcontrib>Kim, B J</creatorcontrib><creatorcontrib>Kang, D-W</creatorcontrib><creatorcontrib>Kwon, S U</creatorcontrib><creatorcontrib>Kim, J-S</creatorcontrib><creatorcontrib>Chang, J Y</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bae, J-H</au><au>Ryu, J-C</au><au>Ha, S H</au><au>Kim, B J</au><au>Kang, D-W</au><au>Kwon, S U</au><au>Kim, J-S</au><au>Chang, J Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Left Vertebral Artery Hypoplasia with Posterior Circulation Stroke and the Functional Outcome of Patients with Atrial Fibrillation-Related Cardioembolic Stroke</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2023-01</date><risdate>2023</risdate><volume>44</volume><issue>1</issue><spage>65</spage><epage>69</epage><pages>65-69</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>A cardiogenic embolus could reach the posterior circulation through the right vertebral artery because of a relatively larger diameter in cases of left vertebral artery hypoplasia. Hence, we investigated whether left vertebral artery hypoplasia is associated with cardiac embolisms with atrial fibrillation in the posterior circulation and its functional outcomes.
In this monocentric retrospective study, patients with acute cardioembolic stroke with atrial fibrillation were enrolled and underwent CT or neck MRA, which visualized the aortic arch and subclavian arteries. The laterality and size of vertebral artery hypoplasia were recorded. Posterior circulation stroke, basilar artery occlusion, and the functional outcomes after 3 months were investigated.
This study included 407 patients; the patients with left vertebral artery hypoplasia experienced a higher rate of posterior circulation stroke (19 versus 73; 42.2% versus 20.2%;
= .001) and basilar artery occlusion (5 versus 10; 11.1% versus 2.8%;
= .005) than the patients without left vertebral artery hypoplasia. Multivariate analysis revealed that left vertebral artery hypoplasia showed an association with lower odds of achieving a good functional outcome 3 months after the stroke (OR = 0.4; 95% CI, 0.2-0.9;
= .027).
Patients with cardioembolic stroke and left vertebral artery hypoplasia had posterior circulation stroke, basilar artery occlusion, and poor functional outcomes after 3 months.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>36521964</pmid><doi>10.3174/ajnr.A7738</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-4880-9258</orcidid><orcidid>https://orcid.org/0000-0002-3278-3252</orcidid><orcidid>https://orcid.org/0000-0002-2999-485X</orcidid><orcidid>https://orcid.org/0000-0002-2926-2368</orcidid><orcidid>https://orcid.org/0000-0002-0935-963X</orcidid><orcidid>https://orcid.org/0000-0002-1538-6642</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0195-6108 |
| ispartof | American journal of neuroradiology : AJNR, 2023-01, Vol.44 (1), p.65-69 |
| issn | 0195-6108 1936-959X |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aorta, Thoracic Arterial Occlusive Diseases - complications Atrial Fibrillation - complications Atrial Fibrillation - diagnostic imaging Embolic Stroke - complications Extracranial Vascular Humans Retrospective Studies Stroke - complications Stroke - diagnostic imaging Vertebral Artery - diagnostic imaging Vertebrobasilar Insufficiency - complications Vertebrobasilar Insufficiency - diagnostic imaging |
| title | Association of Left Vertebral Artery Hypoplasia with Posterior Circulation Stroke and the Functional Outcome of Patients with Atrial Fibrillation-Related Cardioembolic Stroke |
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