High risk of early recurrent stroke in patients with near-occlusion with full collapse of the internal carotid artery

Neuroradiology. 2024 Mar;66(3):349-352. doi: 10.1007/s00234-024-03283-5. Epub 2024 Jan 9.

Abstract

We aimed to validate the prognostic ability and assess interrater reliability of a recently suggested measurement-based definition of near-occlusion with full collapse (distal ICA diameter ≤ 2.0 mm and/or ICA ratio ≤ 0.42). 118 consecutive patients with symptomatic near-occlusion were prospectively included and assessed on computed tomography angiography by 2 blinded observers, 26 (22%) had full collapse. At 2 days after presenting event, the risk of preoperative stroke was 3% for without full collapse and 16% for with full collapse (p = 0.01). At 28 days, this risk was 16% for without full collapse and 22% for with full collapse (p = 0.22). Interrater reliability was perfect (kappa 1.0). Thus, near-occlusion with full collapse should be defined as distal ICA ≤ 2.0 mm and/or ICA ratio ≤ 0.42 in order to detect cases with very high risk of early stroke recurrence.

Keywords: Carotid stenosis; Full collapse; Near-occlusion; Risk; Stroke.

MeSH terms

  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Stenosis* / surgery
  • Cerebral Infarction
  • Humans
  • Reproducibility of Results
  • Retrospective Studies
  • Stroke* / diagnostic imaging
  • Stroke* / etiology