Tariq Muhammad Bilal, Kaneko Naoki, Prochilo Grace, Hinman Jason D, Liebeskind David S
UCLA Comprehensive Stroke Center, Department of Neurology, University of California, Los Angeles, CA, USA.
Division of Interventional Neuroradiology, Department of Radiological Sciences, University of California, Los Angeles, CA, USA.
Stroke Vasc Interv Neurol. 2024 Sep;4(5). doi: 10.1161/SVIN.124.001344. Epub 2024 Apr 23.
Intracranial atherosclerosis is a leading cause of stroke with a high recurrence rate despite treatment. Numerous factors are proposed to influence stroke recurrence due to intracranial atherosclerosis including lesion eccentricity, plaque characteristics, and computational fluid dynamic metrics, such as wall shear stress. An overlooked variable that intrinsically relates to intracranial atherosclerosis is the location of the arterial segment where the lesion occurs. Variations in cerebral blood flow, arterial anatomy, and flow dynamics are likely drivers of initial lesion development and thus likely to influence stroke recurrence. To date, treatment trials of intracranial atherosclerosis have not considered arterial segment lesion location as an independent variable, failing to account for variations in flow dynamics between each artery. There are limited available data on differences between arterial segments, confined to only analyses. In this review, we summarize available data on such differences between arterial segments. With the limited arterial segment data available, multiple differences in recurrence of stroke in territory of lesion were identified across trials.
颅内动脉粥样硬化是中风的主要原因，尽管进行了治疗，但复发率仍很高。许多因素被认为会影响颅内动脉粥样硬化导致的中风复发，包括病变偏心度、斑块特征以及计算流体动力学指标，如壁面剪应力。一个与颅内动脉粥样硬化内在相关但被忽视的变量是病变发生的动脉节段位置。脑血流量、动脉解剖结构和血流动力学的变化可能是初始病变发展的驱动因素，因此可能影响中风复发。迄今为止，颅内动脉粥样硬化的治疗试验尚未将动脉节段病变位置作为一个独立变量，未能考虑各动脉之间血流动力学的差异。关于动脉节段之间差异的可用数据有限，仅限于仅有的分析。在本综述中，我们总结了关于动脉节段之间此类差异的可用数据。由于可用的动脉节段数据有限，在各项试验中发现了病变区域中风复发的多个差异。
