This Article Full Text Full Text (PDF) All Versions of this Article: 40/3/726    most recent STROKEAHA.108.526434v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Balucani, C. Search for Related Content PubMed PubMed Citation Articles by Balucani, C. Pubmed/NCBI databases Medline Plus Health Information Diagnostic Imaging Related Collections Imaging Acute Cerebral Infarction Angiography Computerized tomography and Magnetic Resonance Imaging Doppler ultrasound, Transcranial Doppler etc. Other imaging

(Stroke. 2009;40:726.)
© 2009 American Heart Association, Inc.

Original Contributions

Detection of Intracranial Atherosclerosis

Which Imaging Techniques Are Available in European Hospitals?

Clotilde Balucani, MD; Didier Leys, MD, PhD; E. Bernd Ringelstein, MD, PhD; Markku Kaste, MD, PhD; Werner Hacke, MD, PhD for the Executive Committee of the European Stroke Initiative

From University of Lille (C.B., D.L.), Lille, France; University of Münster (E.B.R.), Münster, Germany; University of Helsinki (M.K.), Helsinki, Finland; University of Heidelberg (W.H.), Heidelberg, Germany.

Correspondence to Didier Leys, Department of Neurology, University Hospital of Lille, 59037 Lille, France. E-mail dleys{at}chru-lille.fr

Background and Purpose— The diagnosis of intracranial atherosclerosis requires availability of appropriate imaging techniques. The objective was to evaluate the proportion of European hospitals where imaging techniques necessary to detect intracranial atherosclerosis are available.

Method— We randomly selected 886 hospitals in 25 countries and classified them in 3 categories according to the availability of 3 imaging techniques (transcranial color-coded duplex imaging, computed tomographic angiography, and magnetic resonance angiography): "all" when the 3 techniques were available, "at least 1," and "none." We compared the proportion of hospitals meeting these criteria, using the odds ratio method and Germany as reference.

Results— Two hundred seventy-two hospitals (30.7%) met criteria for all, 445 (50.2%) met criteria for at least 1, and 169 (19.1%) met criteria for none. In 2005, they had admitted, respectively, 139,118, 160, 393, and 62 667 stroke patients. Brain CT or MRI were available in 820 (92.6%) hospitals, computed tomographic angiography in 619 (69.9%), magnetic resonance angiography in 498 (56.2%), and transcranial color-coded duplex in 352 (39.7%). Compared to Germany, Greece (OR, 0.11; 95% CI, 0.01–0.88), Iberic countries (OR, 0.11; 95% CI, 0.05–0.27), Baltic countries (OR, 0.13; 95% CI, 0.03–0.56), Poland (OR, 0.40; 95% CI, 0.21–0.77), and France (OR, 0.52; 95% CI, 0.31–0.89), had significantly less hospitals in the all group.

Conclusion— In Europe, less than one-third of ischemic stroke patients are admitted in hospitals with all imaging techniques available to detect intracranial atherosclerosis. There are important differences between countries.

Key Words: atherosclerosis • stroke care • stroke unit • survey