2012/10/11 by Matthew L. Flaherty, Brett Kissela, Jane C. Khoury +9
Medicine · #Acute Ischemic Stroke Management #Cardiology #Carotid arteries #Cerebrovascular and Carotid Artery Diseases #Common carotid artery #Incidence (geometry) #Internal carotid artery #Internal medicine #Ischemia #Ischemic stroke #Medicine #Moyamoya disease diagnosis and treatment #Occlusion #Population #Stenosis #Stroke (engine)
paper · pdf · doi:10.1159/000341410
crossref issued 2012/10/11 · crossref published 2012/10/11 · crossref published-online 2012/10/11 · openalex publication_date 2012/10/11 · crossref created 2012/10/19 · crossref published-print 2013/01/01 · crossref deposited 2025/04/23 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01 · crossref indexed 2026/08/06
BACKGROUND: Population-based studies have estimated that about 15% of ischemic strokes are caused by large-vessel cerebrovascular disease. We determined the types of large-vessel atherosclerosis responsible for ischemic strokes in a population-based stroke study. METHODS: Patients with first-ever or recurrent ischemic stroke in the Greater Cincinnati area were identified during 2005 at all local hospitals. Study physicians assigned ischemic stroke subtypes. Overall event rates and incidence rates for first-ever events were calculated, and age-, race- and sex-adjusted to the 2000 US population. RESULTS: There were 2,204 ischemic strokes, including 365 strokes of large-vessel subtype (16.6% of all ischemic strokes). Extracranial internal carotid artery (ICA) stenosis was associated with 8.0% of all ischemic strokes, while extracranial ICA occlusion and intracranial atherosclerosis were each associated with 3.5% of strokes. The annual rate of first-ever and recurrent stroke attributed to extracranial ICA was 13.4 (11.4-15.4) per 100,000 persons. We conservatively estimate that about 41,000 strokes may be attributed to extracranial ICA stenosis annually in the United States. CONCLUSIONS: Large-vessel atherosclerosis is an important cause of stroke, with extracranial ICA stenosis being significantly more common than extracranial ICA occlusion or intracranial atherosclerotic disease.