Association Between Extracranial Artery Stenosis and Cerebral Small-Vessel Disease in Patients with Ischemic Stroke

Authors

• Ahmad Ghoochani-Khorasani, Research Center for Trauma in Police Operations, Directorate of Health, Rescue&Treatment, Police Headquarter, Tehran, Iran AND Associate professor, Department of Medical Sciences, Amin Comprehensive University of Police Sciences, Tehran, Iran
• Seyed Hadi Aghili, Research Center for Trauma in Police Operations, Directorate of Health, Rescue&Treatment, Police Headquarter, Tehran, Iran AND Neurosurgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
• Seyed Zakaria Hosseini, Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, IranFollow
• Seyed Amir Hasan Habibi, Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
• Mehri FarhangRanjbar, Department of Support and Services Management, Institute of Management and Organizational Resources, Policing Sciences and Social Studies Research Institute, Tehran, Iran AND Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
• Mahdi Abdi, Department of Radiology, Valiasr Hospital, Tehran, Iran

Abstract

Objective: To review the relationship between extracranial artery stenosis (ECAS) severity and total cerebral small-vessel disease (CSVD) burden and evaluated 5-year mortality, disability, and stroke recurrence in ischemic stroke patients. Cerebral small-vessel disease and ECAS often share risk factors such as hypertension and atherosclerosis and coexist in ischemic stroke. Although ECAS affects large-artery disease, its impact on total CSVD burden on MRI and subsequent clinical outcomes is not well defined.

Methods: We retrospectively reviewed the medical records of 348 patients older than 35 who had suffered acute ischemic stroke and were admitted to selected hospitals in Tehran, Iran from March 2018–March 2020. The patients were stratified into 4 ECAS groups, and brain MRIs were scored to yield a total CSVD burden score. Ordinal logistic regression was used to examine the association between ECAS category and CSVD score, adjusting for age, sex, hypertension, diabetes mellitus, and hyperlipidemia. Logistic regression assessed 5-year outcomes.

Results: Of the 309 patients with complete imaging, increasing ECAS severity was independently associated with a higher CSVD burden (adjusted OR 1.86; 95% CI 1.56–2.22; p<0.001). Five-year mortality was 39.9%, and severe ECAS predicted lower survival rates (adjusted OR 2.43; 95% CI 1.02–5.78; p = 0.045). However, ECAS was not linked to disability (p = 0.077) or recurrence (p = 0.191).

Conclusions: We found that ECAS severity correlated with greater CSVD burden and poorer long-term survival in ischemic stroke.

Article Type

Original Study

First Page

55

Last Page

59

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Recommended Citation

Ghoochani-Khorasani, Ahmad; Aghili, Seyed Hadi; Hosseini, Seyed Zakaria; Habibi, Seyed Amir Hasan; FarhangRanjbar, Mehri; and Abdi, Mahdi (2026) "Association Between Extracranial Artery Stenosis and Cerebral Small-Vessel Disease in Patients with Ischemic Stroke," Neurosciences: Vol. 31: Iss. 1, Article 8.
DOI: https://doi.org/10.17712/1658-3183.1007