Prevalence of intracranial artery stenosis in a general population using 3D-time of flight magnetic resonance angiography

Liv-Hege Johnsen; Marit Herder; Torgil Vangberg; Jørgen Gjernes Isaksen; Ellisiv B Mathiesen

doi:10.1016/j.jstrokecerebrovasdis.2023.107399

Prevalence of intracranial artery stenosis in a general population using 3D-time of flight magnetic resonance angiography

J Stroke Cerebrovasc Dis. 2023 Dec;32(12):107399. doi: 10.1016/j.jstrokecerebrovasdis.2023.107399. Epub 2023 Oct 20.

Authors

Liv-Hege Johnsen¹, Marit Herder², Torgil Vangberg³, Jørgen Gjernes Isaksen⁴, Ellisiv B Mathiesen⁵

Affiliations

¹ Department of Radiology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Medicine, UiT The Arctic University of Norway, Tromsø, Norway. Electronic address: liv-hege.johnsen@uit.no.
² Department of Radiology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
³ Department of Clinical Medicine, Faculty of Medicine, UiT The Arctic University of Norway, Tromsø, Norway; PET Imaging Center, University Hospital of North Norway, Tromsø, Norway.
⁴ Department of Clinical Medicine, Faculty of Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology, and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.
⁵ Department of Clinical Medicine, Faculty of Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway.

PMID: 37866296
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107399

Abstract

Background: Data on prevalence of intracranial artery stenosis (ICAS) in Western populations is sparse. The aim of the study was to assess the prevalence and risk factors for ICAS in a mainly Caucasian general population.

Methods: We assessed the prevalence of ICAS in 1847 men and women aged 40 to 84 years who participated in a cross-sectional population-based study, using 3-dimensional time-of-flight 3 Tesla magnetic resonance angiography. ICAS was defined as a focal luminal flow diameter reduction of ≥50 %. The association between cardiovascular risk factor levels and ICAS was assessed by multivariable regression analysis.

Results: The overall prevalence of ICAS was 6.0 % (95 % confidence interval (CI) 5.0-7.2), 4.3 % (95 % CI 3.1-5.7) in women and 8.0 % (95 % CI 6.3-10.0) in men. The prevalence increased by age from 0.8 % in 40-54 years age group to 15.2 % in the 75-84 years age group. The majority of stenoses was located to the internal carotid artery (52.2 %), followed by the posterior circulation (33.1 %), the middle cerebral artery (10.8 %) and the anterior cerebral artery (3.8 %). The risk of ICAS was independently associated with higher age, male sex, hypertension, hyperlipidemia, diabetes mellitus, current smoking and higher BMI.

Conclusions: The prevalence of ICAS in a general population of Caucasians was relatively high and similar to the prevalence of extracranial internal carotid artery stenosis in previous population-based studies.

Keywords: Cerebrovascular disease; Epidemiology; Intracranial stenosis; Stroke.

MeSH terms

Adult
Aged
Aged, 80 and over
Anterior Cerebral Artery
Carotid Stenosis* / diagnostic imaging
Carotid Stenosis* / epidemiology
Constriction, Pathologic / epidemiology
Cross-Sectional Studies
Female
Humans
Intracranial Arteriosclerosis* / diagnostic imaging
Intracranial Arteriosclerosis* / epidemiology
Magnetic Resonance Angiography
Male
Middle Aged
Prevalence
Risk Factors