PT  - JOURNAL ARTICLE
AU  - Qing Li
AU  - Yinghua Zhou
AU  - Yingqi Xing
AU  - Jie Yang
AU  - Yang Hua
TI  - Effect of haemodynamics on the risk of ischaemic stroke in patients with severe vertebral artery stenosis
AID  - 10.1136/svn-2021-001283
DP  - 2022 Jun 01
TA  - Stroke and Vascular Neurology
PG  - 200--208
VI  - 7
IP  - 3
4099  - http://svn.bmj.com/content/7/3/200.short
4100  - http://svn.bmj.com/content/7/3/200.full
SO  - Stroke Vasc Neurol2022 Jun 01; 7
AB  - Objectives Endovascular treatment strategies to optimise individualised care for patients with vertebral artery (VA) stenosis need to be revisited. This study aimed to investigate the relationship between net VA flow volume (NVAFV) and the risk of posterior circulation infarction (PCI) in a high-risk patient population.Methods We screened 1239 patients with extracranial VA stenosis, of whom 321 patients with severe VA V1 segment stenosis (≥70%) were enrolled in our study. We restratified the patients based on NVAFV and contralateral VA stenosis grades to analyse the proportion of each PCI mechanism—large artery atherosclerosis and branch artery occlusive disease. Furthermore, we estimated the incidence of recurrent ischaemic stroke between groups with different NVAFV over a follow-up period of 2 years.Results NVAFV was lower in the PCI group. Multiple logistic regression analysis showed that NVAFV is an independent risk factor for PCI and that the OR for PCI for the lowest NVAFV (<112.8 mL/min) was 4.19 (1.76 to 9.95, p=0.001). In patients with severe carotid artery disease, the OR for the lowest NVAFV was 14.03 (3.18 to 61.92, p<0.001). The lower NVAFV group had a higher incidence of recurrent ischaemic stroke events than the higher NVAFV group (HR 2.978, 95% CIs 1.414 to 6.272).Conclusion Our study demonstrated that NVAFV, as estimated by colour duplex ultrasonography, was associated with the incidence of PCI and subsequent ischaemic events and that a high-risk population could be identified for further posterior circulation revascularisation.Data are available upon reasonable request. Not applicable.