Morphological Features of the Vertebrobasilar System Predict Ischemic Stroke Risk in Spontaneous Vertebral Artery Dissection.

Publisher: Springer Country of Publication: United States NLM ID: 101468585 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1937-5395 (Electronic) Linking ISSN: 19375387 NLM ISO Abbreviation: J Cardiovasc Transl Res Subsets: MEDLINE

Original Publication: New York, NY : Springer

Vertebral Artery Dissection*/diagnostic imaging ; Vertebral Artery Dissection*/complications ; Ischemic Stroke*/etiology ; Ischemic Stroke*/diagnosis ; Vertebral Artery*/diagnostic imaging ; Predictive Value of Tests*; Humans ; Female ; Male ; Risk Factors ; Middle Aged ; Risk Assessment ; Adult ; Reproducibility of Results ; Decision Support Techniques ; Prognosis ; Retrospective Studies ; Computed Tomography Angiography ; Aged ; Cerebral Angiography/methods ; Patient-Specific Modeling

The vertebral artery's morphological characteristics are crucial in spontaneous vertebral artery dissection (sVAD). We aimed to investigate morphologic features related to ischemic stroke (IS) and develop a novel prediction model. Out of 126 patients, 93 were finally analyzed. We constructed 3D models and morphological analyses. Patients were randomly classified into training and validation cohorts (3:1 ratio). Variables selected by LASSO - including five morphological features and five clinical characteristics - were used to develop prediction model in the training cohort. The model exhibited a high area under the curve (AUC) of 0.944 (95%CI, 0.862-0.984), with internal validation confirming its consistency (AUC = 0.818, 95%CI, 0.597-0.948). Decision curve analysis (DCA) indicated clinical usefulness. Morphological features significantly contribute to risk stratification in sVAD patients. Our novel developed model, combining interdisciplinary parameters, is clinically useful for predicting IS risk. Further validation and in-depth research into the hemodynamics related to sVAD are necessary.
Competing Interests: Declarations. Ethical Approval: The Ethical Review Committee of West China Hospital of Sichuan University (Approval No. 2020(69)) and individual consent for this retrospective analysis was waived. Informed Consent: Individual consent for this retrospective analysis was waived. Competing Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article.
(© 2024. The Author(s).)

J Integr Neurosci. 2022 Sep 20;21(6):157. (PMID: 36424760)
J Headache Pain. 2012 Apr;13(3):247-53. (PMID: 22350749)
Circulation. 2011 Apr 12;123(14):1537-44. (PMID: 21444882)
Front Neurol. 2022 Jul 28;13:939001. (PMID: 35968293)
Vasc Health Risk Manag. 2022 Sep 02;18:685-700. (PMID: 36082197)
Neurologist. 2023 Sep 01;28(5):281-286. (PMID: 36715669)
J Biomech Eng. 2004 Aug;126(4):516-8. (PMID: 15543870)
Med Sci Monit. 2021 Mar 10;27:e929445. (PMID: 33746200)
Ann Biomed Eng. 2013 Jul;41(7):1411-27. (PMID: 23229281)
Neurology. 2021 Feb 16;96(7):e1005-e1011. (PMID: 33397774)
AJNR Am J Neuroradiol. 2014 Jul;35(7):1254-62. (PMID: 23598838)
BMJ. 2015 Jun 02;350:h2622. (PMID: 26037412)
Comput Methods Biomech Biomed Engin. 2016 Nov;19(14):1541-9. (PMID: 27052093)
J Stroke Cerebrovasc Dis. 2020 Apr;29(4):104636. (PMID: 32008922)
Acad Radiol. 2012 Nov;19(11):1362-7. (PMID: 22906594)
Neurosurgery. 2001 Apr;48(4):949-53; discussion 953-4. (PMID: 11322459)
J Biomech Eng. 2011 May;133(5):051009. (PMID: 21599100)
J Biomech. 2016 Jun 14;49(9):1570-1582. (PMID: 27062590)
BMJ. 2015 Jan 07;350:g7594. (PMID: 25569120)
J Neuroradiol. 2023 Sep;50(5):523-529. (PMID: 36907266)
J Am Heart Assoc. 2023 Oct 3;12(19):e029518. (PMID: 37776192)
J Neurosurg. 2004 Jul;101(1):108-13. (PMID: 15255260)
J Neurosurg. 2010 Oct;113(4):810-9. (PMID: 20136394)
J Neurointerv Surg. 2023 Apr;15(4):321-324. (PMID: 35387859)
JAMA. 2021 Mar 16;325(11):1088-1098. (PMID: 33724327)
Int J Stroke. 2015 Apr;10(3):360-3. (PMID: 23227939)
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104992. (PMID: 32689597)
Front Neurol. 2020 Dec 23;11:534096. (PMID: 33424734)
Front Neurosci. 2023 Jun 14;17:1179963. (PMID: 37389359)
J Am Coll Cardiol. 2020 Apr 21;75(15):1819-1831. (PMID: 32299594)
Sci Rep. 2020 Jun 1;10(1):8904. (PMID: 32483170)
Neural Plast. 2022 Mar 24;2022:4280410. (PMID: 35369646)
Eur J Radiol. 2019 Jul;116:84-89. (PMID: 31153579)
J Magn Reson Imaging. 2023 Jan;57(1):113-123. (PMID: 35652452)
J Neurosurg. 2011 Jul;115(1):108-12. (PMID: 21417706)
J Vasc Surg. 2021 Aug;74(2):396-403. (PMID: 33548438)
J Neuroimaging. 2017 Sep;27(5):499-504. (PMID: 28276103)
Biomed Res Int. 2021 Apr 27;2021:5527988. (PMID: 33996998)
Interv Neuroradiol. 2022 Dec;28(6):765-772. (PMID: 34866439)
J Biomech Eng. 1981 Aug;103(3):204-7. (PMID: 7278199)
Front Physiol. 2021 Apr 16;12:645438. (PMID: 33935800)
Biomech Model Mechanobiol. 2010 Oct;9(5):629-40. (PMID: 20224897)
J Stroke Cerebrovasc Dis. 2019 Mar;28(3):693-698. (PMID: 30482487)
Folia Morphol (Warsz). 2021;80(1):1-12. (PMID: 32073130)
J Emerg Med. 2016 Nov;51(5):508-518. (PMID: 27634674)
Stroke. 2019 Aug;50(8):2231-2233. (PMID: 31221053)

2022YSF019 the Science and Technology Planning Project of Sichuan Province; 82101395 the Natural Science Foundation of China; 2023NSFSC1562 the Sichuan Science and Technology Program

Keywords: Morphological Features; VAD; Vertebral Artery Dissection; Vertebral Artery Ostium; Vertebrobasilar System

Date Created: 20240709 Date Completed: 20241211 Latest Revision: 20241214

20241214

PMC11634921

10.1007/s12265-024-10534-6

38980655