AUTHOR=Hou Zhikai , Li Mingyao , Lyu Jinhao , Xu Ziqi , Liu Yifan , He Jianfeng , Jing Jing , Wang Rong , Wang Yongjun , Lou Xin , Miao Zhongrong , Ma Ning 

TITLE=Intraplaque Enhancement Is Associated With Artery-to-Artery Embolism in Symptomatic Vertebrobasilar Atherosclerotic Diseases

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.680827

DOI=10.3389/fneur.2021.680827

ISSN=1664-2295

ABSTRACT=Abstract
Objective
We try to compare whether the plaque characteristics and baseline features are different in patients with A-to-A (Artery-to-Artery) embolism and those with parent artery disease in the intracranial vertebrobasilar atherosclerotic disease.
Methods
From September 2014 to January 2017, patients with recent posterior circulation stroke due to intracranial vertebrobasilar atherosclerotic disease were analyzed. The plaque characteristics, including intraplaque compositions (intraplaque hemorrhage and intraplaque calcification), intraplaque enhancement, and remodeling index, were evaluated by using 3T high-resolution magnetic resonance imaging (HRMRI). The baseline features including vascular risk factors and the involved artery were collected. Patients were divided into A-to-A embolism and parent artery disease groups based on the diffusion-weighted images, T2-weighted images, or computed tomography. The plaque characteristics and baseline features were compared between the two groups.
Results
Among consecutive 298 patients, 51 patients were enrolled. 29 patients were A-to-A embolism and 22 patients were parent artery disease. Compared with parent artery disease, the occurrence rates of intraplaque enhancement and intracranial vertebral involvement were higher in the A-to-A embolism group (79.3% versus 36.4%; p=0.002 and 62.1% versus 18.2%; p=0.002, respectively). Multivariable logistic regression analysis showed intraplaque enhancement and intracranial vertebral artery plaques were also associated with A-to-A embolism. (adjusted OR, 7.31; 95%CI, 1.58-33.77; p=0.011 and adjusted OR, 9.42; 95%CI, 1.91-46.50; p=0.006, respectively).
Conclusion
Intraplaque enhancement and intracranial vertebral artery plaques seem to be more closely associated with A-to-A embolism than parent artery disease in patients with symptomatic intracranial vertebrobasilar disease.