The Relation Between Aortic Arch Branching Types And The Location Of Large Vessel Occlusion In Cardioembolic Stroke

Objective: There are arguments about the left-right propensity of cardioembolic strokes.We aimed to reveal the relationship between the different aortic arch types and the location of large vessel occlusion in cardioembolic stroke.Methods: The clinical data of patients with large vessel occlusion caused by cardiac embolism in the comprehensive stroke center at Yongchuan Hospital of Chongqing Medical University from January 2017 to June 2020 was analyzed retrospectively.Data collected included age,gender,stroke risk factors,location of large vessel occlusion,aortic arch types.Thrombus was classified into large thrombus and small thrombus according to the location of large vessel occlusion.The relation of aortic arch type and location of large vessel occlusion caused by cardiogenic embolism was analyzed.Results: 185 patients were included in the present study,including185 cases of Anterior circulation embolic occlusions.Overall,left-sided strokes(50.8%)in patients with cardioembolic stroke caused by large vessel occlusion were almost equal to right-sided strokes(49.2%).The leftside propensity tended to be higher with advancement of the aortic arch types either in the total cases or in the atrial fibrillation cases,with no statistical difference between the 3 aortic arch types.In type Ⅰ and Ⅱaortic arches,the percentage of left-sided strokes were higher than that of right-sided in small thrombus,while right-sided strokes were more common than left-sided in large thrombus(P<0.05).Conversely,in type Ⅲaortic arch,left-sided strokes(69.0%)were twice than right-sided(31%)in large thrombus(P<0.05),while right-sided strokes(85.7%)were more common than left-sided(14.3%)in small thrombus(P<0.05).Conclusion: Aortic arch type and embolus size may be important influencers for the location of cardioembolic stroke.