Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke

Jihoon Kang, Nayoung Kim, Chang W. Oh, O. Ki Kwon, Chol K. Jung, Wook Joo Kim, Jung H. Park, Youngchai Ko, Won Young Noh, Min U. Jang, Jeong Ho Hong, Ji S. Lee, Juneyoung Lee, Myung S. Jang, Mi H. Yang, Moon Ku Han, Hee Joon Bae

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10 Citations (Scopus)


Background We aimed to assess the impact of symptomatic steno-occlusion (SYSO) of cerebral arteries and its characteristics on subsequent ischemic event (SIE) in patients with acute ischemic stroke. Methods Using a prospective stroke registry database, we identified consecutive patients with ischemic stroke who were hospitalized within 48 hours of symptom onset. SYSO denoted significant stenosis or occlusion of major cerebral arteries with ischemic lesions at the corresponding arterial territories and was characterized by its location and severity. Primary outcome was SIE that was defined as ischemic progression or recurrence within 1 year. Results In total, 1546 patients (age, 67.4 ± 13.0 years; median National Institutes of Health Stroke Scale score, 4) were enrolled in this study. The cumulative risk of SIE was 14.5% at 7 days, 14.9% at 14 days, 15.5% at 90 days, and 16.9% at 1 year. Patients with SYSO had significantly higher SIE rates compared with those without SYSO (23.0% versus 11.6%). Of the characteristics of SYSO, the location, not the severity, was significantly associated with SIE (P <.001 and P =.186, respectively). Multiple (adjusted hazard ratio, 5.85; 95% confidence interval, 1.81-18.85), intracranial internal carotid artery (ICA) (3.54; 1.21-8.21), and extracranial ICA SYSO (2.88; 1.01-8.21) raised the risk of SIE. Conclusions Subsequent cerebral ischemic events (progression or recurrence) after an acute ischemic stroke occur mostly within several days of stroke onset and is associated with the location, but not the severity, of symptomatic steno-occlusion of cerebral arteries. Crown

Original languageEnglish
Pages (from-to)e347-e353
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number5
Publication statusPublished - 2014
Externally publishedYes


  • Ischemia
  • occlusion
  • prognosis
  • stenosis
  • stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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