doi: 10.1161/hs0202.102602
(Stroke. 2002;33:532.)
© 2002 American Heart Association, Inc.
Original Contributions |
Progression of Middle Cerebral Artery Occlusive Disease and Its Relationship With Further Vascular Events After Stroke
From the Division of Neurology, Department of Medicine and Therapeutics (K.S.W., H.L., R.K.), and the Department of Diagnostic Radiology and Organ Imaging (W.W.M.L., Y.L.C.), the Chinese University of Hong Kong, Shatin, Hong Kong, SAR.
Correspondence to Dr Ka Sing Wong, Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR. E-mail ks-wong{at}cuhk.edu.hk
Background— Serial changes of flow velocities of transcranial Doppler ultrasound (TCD) in symptomatic middle cerebral artery (MCA) occlusive disease may be related to the occurrence of further vascular events, but prospective data are lacking.
Methods— We conducted a prospective study on patients with cerebral ischemia who were hospitalized with symptomatic MCA stenosis or occlusion. We repeated TCD examinations 6 months after the initial examinations and recorded any stroke or coronary events during this period. The changes of MCA flow velocities were categorized as normalized artery, stable artery, and progressed artery, which were determined according to the changes of MCA velocities at 6 months.
Results— We studied 143 consecutive patients who had relevant MCA occlusive diseases (107 with stenosis and 36 with occlusion). At 6 months, the velocities in the MCA returned to normal in 42 patients (29%), they were stable in 80 patients (62%), and they progressed in 13 patients (9%). The number of clinical events varied significantly among the 3 groups: there were 2 patients (4.8%) with clinical events in the normal group, 11 patients (12.5%) with clinical events in the stable group, and 5 patients (38.5%) with clinical events in the progressed group (P=0.004). The 18 recurrent events included 10 recurrent strokes, 5 transient ischemic attacks, and 3 acute coronary syndromes.
Conclusions— Progression of MCA occlusive diseases is associated with an increased risk of vascular events. Further studies are required to establish the value of serial TCD examinations in predicting future clinical events.
Key Words: arterial occlusive disease • cerebral ischemia • Chinese • prognosis • ultrasonography, Doppler
This article has been cited by other articles:
 |
|
 |
|
  P. B. Gorelick, K. S. Wong, H.-J. Bae, and D. K. Pandey Large Artery Intracranial Occlusive Disease: A Large Worldwide Burden but a Relatively Neglected Frontier Stroke, August 1, 2008; 39(8): 2396 - 2399. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Arenillas, J. Alvarez-Sabin, C. A. Molina, P. Chacon, I. Fernandez-Cadenas, M. Ribo, P. Delgado, M. Rubiera, A. Penalba, A. Rovira, et al. Progression of Symptomatic Intracranial Large Artery Atherosclerosis Is Associated With a Proinflammatory State and Impaired Fibrinolysis Stroke, May 1, 2008; 39(5): 1456 - 1463. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.-J. Jiang, X.-T. Xu, M. Jin, B. Du, K.-H. Dong, and J.-P. Dai Apollo Stent for Symptomatic Atherosclerotic Intracranial Stenosis: Study Results AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 830 - 834. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.-J. Jiang, B. Du, T. W. Leung, X.-T. Xu, M. Jin, and K.-H. Dong Symptomatic Intracranial Stenosis: Cerebrovascular Complications from Elective Stent Placement Radiology, April 1, 2007; 243(1): 188 - 197. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Liu, W. Li, and Z.-Q. Liu Middle Cerebral Artery Stenosis: Stenting Is One of the Options: Yes Stroke, April 1, 2007; 38(4): 1418 - 1419. [Full Text] [PDF]
|
|
|
|
|
|
W. Yoon, J. J. Seo, K. H. Cho, M. K. Kim, B. C. Kim, M. S. Park, T. S. Kim, J. K. Kim, and H. K. Kang Symptomatic Middle Cerebral Artery Stenosis Treated with Intracranial Angioplasty: Experience in 32 Patients Radiology, November 1, 2005; 237(2): 620 - 626. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. H. Shin, P. H. Lee, and O. Y. Bang Mechanisms of Recurrence in Subtypes of Ischemic Stroke: A Hospital-Based Follow-up Study Arch Neurol, August 1, 2005; 62(8): 1232 - 1237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. U. Kwon, Y.-J. Cho, J.-S. Koo, H.-J. Bae, Y.-S. Lee, K.-S. Hong, J. H. Lee, and J. S. Kim Cilostazol Prevents the Progression of the Symptomatic Intracranial Arterial Stenosis: The Multicenter Double-Blind Placebo-Controlled Trial of Cilostazol in Symptomatic Intracranial Arterial Stenosis Stroke, April 1, 2005; 36(4): 782 - 786. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J K Kim, J Y Ahn, B H Lee, Y S Chung, S S Chung, O J Kim, W C Kim, and J Y Joo Elective stenting for symptomatic middle cerebral artery stenosis presenting as transient ischaemic deficits or stroke attacks: short term arteriographical and clinical outcome J. Neurol. Neurosurg. Psychiatry, June 1, 2004; 75(6): 847 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-J. Jiang, Y.-J. Wang, B. Du, S.-X. Wang, G.-H. Wang, M. Jin, and J.-P. Dai Stenting of Symptomatic M1 Stenosis of Middle Cerebral Artery: An Initial Experience of 40 Patients Stroke, June 1, 2004; 35(6): 1375 - 1380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Sloan, A. V. Alexandrov, C. H. Tegeler, M. P. Spencer, L. R. Caplan, E. Feldmann, L. R. Wechsler, D. W. Newell, C. R. Gomez, V. L. Babikian, et al. Assessment: Transcranial Doppler ultrasonography: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Neurology, May 11, 2004; 62(9): 1468 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. S. Wong and H. Li Long-Term Mortality and Recurrent Stroke Risk Among Chinese Stroke Patients With Predominant Intracranial Atherosclerosis Stroke, October 1, 2003; 34(10): 2361 - 2366. [Abstract] [Full Text] [PDF]
|
|