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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Stephane Olindo (Stroke Unit Bordeaux University Hospital Bordeaux France) Nicolas Chausson (Neurology Department Sud-Francilien Hospital Corbeil-Essonnes France) Aissatou Signate (Neurology Department Martinique University Hospital Martinique) Sylvie Mecharles (Neurology Department Guadeloupe University Hospital Guadeloupe) Jean-Luc Hennequin (Vascular Surgery Department Martinique University Hospital Martinique) Martine Saint-Vil (Neurology Department Martinique University Hospital Martinique) Mireille Edimonana-Kaptue (Neurology Department Martinique University Hospital Martinique) Severine Jeannin (Neurology Department Martinique University Hospital Martinique) Anne Landais (Neurology Department Guadeloupe University Hospital Guadeloupe) Philippe Cabre (Neurology Department Martinique University Hospital Martinique) Igor Sibon (Stroke Unit Bordeaux University Hospital Bordeaux France) Didier Smadja (Neurology Department Sud-Francilien Hospital Corbeil-Essonnes France) Julien Joux (Neurology Department Martinique University Hospital Martinique)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제2호
발행연도
2021.1
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253 - 262 (10page)

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Background and Purpose Carotid web (CaW) is an intimal variant of fibromuscular dysplasia responsible for ipsilateral cerebral ischemic events (CIE). Symptomatic CaW likely has a high risk of recurrent CIE, but no salient prospective data are available. We aimed to assess recurrence rate and its predictors after a first-ever CIE. Methods Consecutive Afro-Caribbean patients who had cryptogenic first-ever CIEs (ischemic stroke [IS] or transient ischemic attack [TIA]) associated with ipsilateral CaW were included in this multicenter observational cohort study. The follow-up (January 2008 to March 2019) focused on CIE recurrences. Kaplan-Meier method assessed rates of recurrences and Cox proportional hazards regression analyzed risk factors. Results Ninety-two patients (79 first-ever ISs and 13 TIAs; mean age±standard deviation, 49.8±9.9 years; 52 [56.5%] women) were included. During a mean follow-up of 50.5±29.6 months, 19 (20.7%) patients experienced recurrent ipsilateral CIEs (16 ISs and three TIAs). Of 23 patients receiving surgery/stenting treatment, no recurrence occurred after the intervention (median follow-up, 39.8 months [interquartile range, 27.6 to 72.4]). Under medical treatment alone, the annual recurrent CIE rate was 6.9%, and the cumulative rate was 4.4% at 30-day, 10.8% at 1-year, 19.8% at 2-year, 23.2% at 3-year, and 27.3% at 5-year. Presence of silent cerebral infarctions was the only independent risk factor of CIE recurrences (hazard ratio, 6.99; 95% confidence interval, 2.4 to 20.4; P=0.004). Conclusions Under medical treatment alone, symptomatic CaW was associated with a high rate of recurrence that reached 27.3% at 5-year. Surgery/stenting seems to be efficient, and randomized control trials are required to confirm the benefit of these interventions.
#Ischemic stroke #Cohort studies #Carotid artery #Recurrence #Carribbean region #Fibromuscular dysplasia

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참고문헌 (31)

참고문헌 신청
Wirth FP / 1981 / Atypical fibromuscular hyperplasia. Report of two cases / J Neurosurg 54:685~689 google schola Morgenlander JC / 1991 / Recurrent transient ischemic attacks and stroke in association with an internal carotid artery web / Stroke 22:94~98 google schola Joux J / 2014 / Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke / Stroke 45:3711~3713 google schola Joux J / 2016 / Association between carotid bulb diaphragm and ischemic stroke in young Afro-Caribbean patients : a population-based case-control study / Stroke 47:2641~2644 google schola Coutinho JM / 2017 / Carotid artery web and ischemic stroke : a case-control study / Neurology 88:65~69 google schola

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