Carotid siphon calcification impact on revascularization and outcome in stroke intervention

Diogo C. Haussen, Brandon G. Gaynor, Jeremiah N. Johnson, Eric Peterson, Mohamed Elhammady, Mohammad A. Aziz-Sultan, Dileep R Yavagal

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective 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. Methods 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). Results 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. Conclusion 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.

Original languageEnglish
Pages (from-to)73-77
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume120
DOIs
StatePublished - Jan 1 2014

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Stroke
Calcium
Carotid Arteries
Reperfusion
Coronary Artery Disease
Internal Carotid Artery
Coronary Disease
Linear Models
Coronary Vessels
Regression Analysis
Brain
Therapeutics

Keywords

  • Atherosclerosis
  • Endovascular procedures
  • Internal carotid artery diseases
  • Stroke
  • Vascular calcification

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Carotid siphon calcification impact on revascularization and outcome in stroke intervention. / Haussen, Diogo C.; Gaynor, Brandon G.; Johnson, Jeremiah N.; Peterson, Eric; Elhammady, Mohamed; Aziz-Sultan, Mohammad A.; Yavagal, Dileep R.

In: Clinical Neurology and Neurosurgery, Vol. 120, 01.01.2014, p. 73-77.

Research output: Contribution to journalArticle

Haussen, Diogo C. ; Gaynor, Brandon G. ; Johnson, Jeremiah N. ; Peterson, Eric ; Elhammady, Mohamed ; Aziz-Sultan, Mohammad A. ; Yavagal, Dileep R. / Carotid siphon calcification impact on revascularization and outcome in stroke intervention. In: Clinical Neurology and Neurosurgery. 2014 ; Vol. 120. pp. 73-77.
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abstract = "Objective 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. Methods 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). Results 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. Conclusion 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.",
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N2 - Objective 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. Methods 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). Results 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. Conclusion 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.

AB - Objective 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. Methods 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). Results 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. Conclusion 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.

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