Haussen Diogo C, Gaynor Brandon G, Johnson Jeremiah N, Peterson Eric C, Elhammady Mohamed Samy, Aziz-Sultan Mohammad A, Yavagal Dileep R
Departments of Neurology and Neurosurgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA.
Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, USA.
Clin Neurol Neurosurg. 2014 May;120:73-7. doi: 10.1016/j.clineuro.2014.02.021. Epub 2014 Mar 5.
The degree of coronary artery calcification has been shown to predict outcomes in coronary artery disease. The impact of intracranial carotid artery calcification on the prognosis of acute ischemic stroke (AIS) is unknown. The authors sought to examine if the degree of intracranial carotid artery calcification influences reperfusion or outcomes in AIS intervention.
All anterior circulation large vessel occlusion AIS cases that underwent intra-arterial therapy from January 2009 to July 2012 were reviewed. Clinical and radiographic data were collected. Non-contrast brain CT scans were assigned a Calcium Extent Score (degree of calcification of the carotid wall circumference), Calcium Thickness Score (thickness of the calcified plaque), and total Carotid Siphon Calcium (CSC) Score (8-point scale).
One-hundred seventeen patients met inclusion criteria. The mean age was 65.4±15.6 years and 36% were male. Calcification was present in the intracranial carotid artery of 84 patients (71%). Inter-rater agreement for total CSC score was strong (Spearman's rho=0.883, p<0.001). The mean Calcium Extent Score was 1.5±1.3, Calcium Thickness Score 1.3±1.0 and total CSC Score 2.8±2.2. Reperfusion and mRS were not associated with CSC. Multivariate linear regression analysis revealed that older age, history of coronary disease and cervical internal carotid occlusion/near-occlusion were independently associated with higher total CSC scores.
Extensive calcification on the intracranial carotid artery does not have impact on reperfusion or clinical outcomes in AIS patients undergoing endovascular therapy. Higher CSC scores are associated with coronary artery disease, increasing age and cervical internal carotid artery occlusion/near-occlusion.
冠状动脉钙化程度已被证明可预测冠状动脉疾病的预后。颅内颈动脉钙化对急性缺血性卒中（AIS）预后的影响尚不清楚。作者旨在研究颅内颈动脉钙化程度是否会影响AIS干预中的再灌注或预后。
回顾了2009年1月至2012年7月间接受动脉内治疗的所有前循环大血管闭塞性AIS病例。收集了临床和影像学数据。对非增强脑部CT扫描进行了钙范围评分（颈动脉壁周长钙化程度）、钙厚度评分（钙化斑块厚度）和总颈动脉虹吸钙（CSC）评分（8分制）。
117例患者符合纳入标准。平均年龄为65.4±15.6岁，36%为男性。84例患者（71%）颅内颈动脉存在钙化。总CSC评分的评分者间一致性很强（Spearman秩相关系数=0.883，p<0.001）。平均钙范围评分为1.5±1.3，钙厚度评分为1.3±1.0，总CSC评分为2.8±2.2。再灌注和改良Rankin量表评分与CSC无关。多变量线性回归分析显示，年龄较大、冠心病史和颈内动脉闭塞/近闭塞与较高的总CSC评分独立相关。
颅内颈动脉广泛钙化对接受血管内治疗的AIS患者的再灌注或临床结局没有影响。较高的CSC评分与冠状动脉疾病、年龄增长和颈内动脉闭塞/近闭塞有关。
