Abstract WP221: Imaging Features and Prognostic Factors for Determining Outcomes in Cervicocerebral Artery Dissection

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Introduction: Imaging findings for the improvement of prognosis are not well established in patients with cervicocerebral artery dissection.

Hypothesis: We aim to identify the imaging outcomes of cervicocerebral artery dissection and prognostic factors which influence improving the imaging outcomes.

Methods: We included 162 consecutive patients diagnosed with cervicocerebral artery dissection on baseline vascular images. Imaging findings on the baseline were obtained within 7 days after symptoms onset, and follow-up vascular images were performed 6 months or 1 year. We compared the radiological features and the degrees of recovery (complete or partial recovery) between baseline and follow-up vascular images.

Results: A total of 70 patients who underwent baseline and 6-month or a year vascular imaging were compared for these analyses. The patient mean age was 48 (SD 11), and the number of females was 21 (30%). The site of a dissection was more common in the posterior circulation (71.4%) and presence of infarction on baseline MRI was 84%. Regarding the lesion sites, a dissection was more common in the intracranial (83%). The baseline vascular images identified an aneurysm in 40% and stenosis or occlusion in 77%. Follow-up images showed complete improvement of the dissected vessels in 78% at 3 months and 83% at 6 months. Patients (n=15) who had an occlusion on the baseline images had partial or complete resolution in 38%. There were no significant differences in efficacy for the partial or complete improvement of vascular lesion on the follow-up images in patients who were treated with antiplatelet (OR=0.68 [0.15-3.10], p=0.72) or anticoagulation treatment (OR=1.38 [0.48-3.97], p=0.60). In the multivariate analysis, the odds ratio for complete or partial improvement on the follow-up vascular images from vertebral artery was 0.16 (0.48-0.52) (p=0.002) after adjustment for age, gender, and eGFR.

Conclusions: In patients who diagnosed with cervicocerebral artery dissection on baseline vascular images, the rate of complete or partial recanalization was over 80% on the 6-month or 1-year follow-up images. Vertebral artery dissection are poor prognostic factors for the recovery of the vascular lesion after cervicocerebral artery dissection.

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