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Abstract Details

Vertebral Artery Origin Stenosis as a Cause of Ischemic Stroke in a Multi-Ethnic Population
Cerebrovascular Disease and Interventional Neurology
P05 - (-)
240
BACKGROUND: Vertebral Artery origin (VAo) stenosis is an important etiology for stroke in the posterior circulation. Data from the New England Registry showed a prevalence of VAo disease of 25% with a direct causal association in 9% of cases. In the Oxford Vascular Study the prevalence of VAo disease was 12%. These populations are largely comprised of Caucasians. The prevalence of VAo disease in the Hispanic community is unknown.
DESIGN/METHODS: The Miami Stroke Registry is a prospective hospital-based registry which has enrolled 992 consecutive patients to date. Of these, 214 (21.6 %) strokes/TIAs involved the posterior circulation. All stroke cases and the associated neuroimaging were reviewed and adjudicated using TOAST classification by vascular neurologists.
RESULTS: Mean age of the population was 62.7+/- 12.6 years; 70.4% were men; 57.8% Hispanic, 32.4% African American, 7.0% white, and 2.8% unknown. Hypertension was found in 74.2%, hyperlipidemia 63.8%, and diabetes in 34.2% of cases. The most common etiology of posterior cirulation strokes was small vessel disease (28.6%), followed by large vessel disease (28.2%), cardioembolism (18.8%) and crytogenic stroke (12.2%). VAo stenosis/occlusion was present in 28 (13.1%) patients of whom only 2 (0.9%) were bilateral; it was attributed as the direct cause of stroke in 11 (5.2%) patients. In univariate analysis patients with any VAo stenosis/occlusion were older (66+/-12 vs. 61+/-12, p=0.028) and whites had more VAo stenosis (20%) than Hispanics (11.4%, p=0.018), but no differences were found in hypertension, diabetes, and dyslipidemia. In a multivariate model, only age remained independently associated with VAo stenosis.
CONCLUSIONS: We found a lower prevalence of VAo stenosis in a predominately non-white population with posterior circulation stroke than previously reported. VAo stenosis was a direct cause of posterior circulation stroke in only 5.2% of patients.
Authors/Disclosures
Gillian L. Gordon-Perue, MD, FAAN (University of Miami)
PRESENTER 		The institution of Dr. Gordon-Perue has received research support from CDC Paul Coverdell Grant. The institution of Dr. Gordon-Perue has received research support from Florida Department of Health. Dr. Gordon-Perue has received personal compensation in the range of $500-$4,999 for serving as a Moderator with PRIME ECHO Stroke 好色先生al Webinar.
Amirhossein Zangiabadi, MD No disclosure on file
Ram N. Narayan, MD, FAAN (Barrow Neurological Institute) Dr. Narayan has nothing to disclose.
Michael Katsnelson, MD No disclosure on file
Jose G. Romano, MD, FAAN (University of Miami, Miller School of Medicine) Dr. Romano has stock in Vycor Medical/NovaVision. The institution of Dr. Romano has received research support from NIH/NINDS. The institution of Dr. Romano has received research support from NIH/NHLBI.
Tatjana Rundek, MD, PhD The institution of Dr. Rundek has received research support from NIH.
Ralph L. Sacco, MD, MS, FAHA Dr. Sacco has received personal compensation in the range of $100,000-$499,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Sacco has received research support from NIH, NINDS, NCATS, NIMHD. The institution of Dr. Sacco has received research support from FL Department of Health. Dr. Sacco has received research support from University of Washington, Seattle. Dr. Sacco has received publishing royalties from a publication relating to health care.
Rohit Bakshi, MD, FAAN Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Bakshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. The institution of Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuroimaging. The institution of Dr. Bakshi has received research support from Bristol Myers Squibb. The institution of Dr. Bakshi has received research support from EMD Serono. The institution of Dr. Bakshi has received research support from Novartis.
Sebastian Koch, MD (University of Miami) Dr. Koch has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Multiple Legal Matters. Dr. Koch has received stock or an ownership interest from Cerepeutics. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care.