Angiographic Patterns Of M1 Stenosis Predicts Risk Of Recurrent Territorial Ischemic Stroke

Background and Objective:Intracranial atherosclerosis stenosis（ICAS）is one of the major causes of ischemic stroke,which has a high mortality and disability rate.The risk of recurrent stroke in patients with ICAS is great significance for patient’s prognosis and treatment（aggressive medical therapy or endovascular treatment）.MethodsThe patients with symptomatic ICAS（stenotic M1 of middle cerebral artery）diagnosed by cerebral angiography from January 2016 to December2019 without stenting were retrospectively searched in our hospital information system.And three different angiographic patterns are identified（normal,shift and dilation）.The association between these patterns and recurrent ischemic stroke in the M1 territory was analyzed.Results:A total of 124 patients with symptomatic M1 stenosis,the normal,shift and dilatation pattern observed on angiography was 61（49.2%）,49（39.5%）,and 14（11.3%）,respectively.The rates of recurrent M1 territorial stroke and transient ischemic attack（TIA）in the normal group,shift group and dilation group are 47.5%,36.7% and 85.7%,respectively（p<0.05）.In patients with the shift pattern,the rate of recurrent stroke is significantly higher at a deflection angle ≥ 9.81° than at a deflection angle <9.81°（p<0.05）.Conclusions:The angiographic pattern of M1 stenosis can predict recurrent territorial strokes,which may be used as an evaluation method to identify high-risk patients for providing imaging feature for the selection of treatment strategies of ICAS...