Presenter of 2 Presentations
CHARACTERISTICS OF WALL SHEAR STRESS ACCORDING TO MECHANISM OF ISCHEMIC STROKE WITH ATHEROSCLEROTIC PLAQUE OF MIDDLE CEREBRAL ARTERY
CHARACTERISTICS OF WALL SHEAR STRESS ACCORDING TO MECHANISM OF ISCHEMIC STROKE WITH ATHEROSCLEROTIC PLAQUE OF MIDDLE CEREBRAL ARTERY
Abstract
Background and Aims
The mechanism of stroke caused by atherosclerotic plaque of middle cerebral artery (MCA) was differed according to the pattern of lesion. The aim of this study was to compare the characteristics of wall shear stress (WSS) according to the stroke mechanism in the patients with atherosclerotic plaque of MCA.
Methods
We prospectively recruited consecutive patients with symptomatic and asymptomatic atherosclerosis of the MCA (≥50% diameter stenosis). The mechanism of stroke caused by atherosclerosis of the MCA was determined by a lesion pattern on diffusion-weighted image. The characteristics of the MCA plaque and WSS were measured by high-resolution vessel wall imaging and GT-Flow software. The characteristics of the MCA plaque and WSS were compared among patients with asymptomatic atherosclerosis of the MCA and those with stroke caused by different mechanism.
Results
A total of 110 patients (46 asymptomatic, 32 artery-to-artery embolism, and 32 local branch occlusion) were investigated. Plaque in the distal MCA was more common in the artery-to-artery embolism patients and plaque in the middle MCA was more common in the local branch occlusion patients. Location of plaque enhancement and maximum WSS in the artery-to-artery embolism patients were more prevalent in the upstream point and those in the local branch occlusion patients were more prevalent in minimum lumen area. Elevated variability of maximal WSS was related to the stroke caused by artery-to-artery embolism.
Conclusions
Stroke caused by artery-to-artery embolism are more related to the elevated variability of maximum WSS and are commonly developed at upstream point of plaque.