Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Introduction: Patients with symptomatic high-grade intracranial atherosclerotic disease (ICAD) are at risk of stroke recurrence even under stringent medical therapy. Understanding how the plaque evolves in these patients may help prevent recurrent stroke.Methods: In a prospective, multicenter referral, longitudinal study, we recruited 40 patients (mean age = 61.1 years) with symptomatic high-grade ICAD (70-99% stenosis) confirmed by 3-dimensional rotational angiography (3DRA) from July 2007 to Feb 2016. All patients had 3DRA at baseline and 1 year. All patients received contemporary optimal medical treatment. We assessed the morphological features of qualifying ICAD lesions in the paired 3DRA images. A plaque was considered progressive if the plaque surface evolved from being smooth to irregular/ulcerated or from irregular to ulcerated, or the affected artery occluded at 1 year. We explored factors associated with plaque progression.Results: The qualifying ICAD lesions were in average 77.7% stenosis at baseline. The point of maximum stenosis was located at the distal end of the plaques in 21 (52.5%) cases, and 38 (95.0%) patients had eccentric plaques at baseline. The mean upstream plaque shoulder angulation was 46.4° at baseline. Eleven (27.5%) ICAD lesions progressed from baseline to 1 year. Longer lesions (p=0.038) with a smaller upstream plaque shoulder angulation (p=0.038) and the maximum stenosis locating at the distal end of the lesion (p=0.056) at baseline were more likely to progress in the plaque morphology over 1 year.Conclusions: Under modern medical treatment, although the majority of symptomatic ICAD lesions might regress over 1 year after an index stroke, lesions of a longer length, a smaller upstream angulation, or with the maximum stenosis located at the distal end were more likely to progress in terms of the plaque morphology.Author Disclosures: X. Leng: None. L. Wang: None. X. Zou: None. Y.O. Soo: None. A.Y. Chan: None. V.H. Ip: None. F.S. Fan: None. V.C. Mok: None. L.K. Wong: None. S.C. Yu: None. T.W. Leung: None.


Conference paper

Publication Date