Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups
Background Intracranial atherosclerosis (ICAD) is a common cause of stroke globally. We calculated the proportion of patients with stroke with symptomatic intracranial atherosclerosis in an Australian multiethnic setting, as well as diagnostic rates by stroke physicians and radiologists. Methods Thi...
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Wiley
2025-01-01
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| Series: | Stroke: Vascular and Interventional Neurology |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.124.001397 |
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| author | Davor Pavlin‐Premrl Michael Waters Vincent Thijs Peter J. Mitchell Nawaf Yassi Mark W. Parsons Louise Weir Lauren Pesavento Julian Maingard Geoffrey Cloud Vimal Stanislaus Mei Ngun Bruce C.V. Campbell |
| author_facet | Davor Pavlin‐Premrl Michael Waters Vincent Thijs Peter J. Mitchell Nawaf Yassi Mark W. Parsons Louise Weir Lauren Pesavento Julian Maingard Geoffrey Cloud Vimal Stanislaus Mei Ngun Bruce C.V. Campbell |
| author_sort | Davor Pavlin‐Premrl |
| collection | DOAJ |
| description | Background Intracranial atherosclerosis (ICAD) is a common cause of stroke globally. We calculated the proportion of patients with stroke with symptomatic intracranial atherosclerosis in an Australian multiethnic setting, as well as diagnostic rates by stroke physicians and radiologists. Methods This was a multicenter retrospective cohort study based in Melbourne, Australia. Demographic data (including self‐reported ethnicity) and data on vascular risk factors were collected. Symptomatic ICAD was independently identified by 2 blinded stroke neurologists using multiplanar reformats and maximum intensity projections of routinely acquired thin slice computed tomography angiography data, with disagreements resolved by a third blinded stroke neurologist. This diagnostic reference standard was compared to the proportion of patients with ICAD identified in the radiology report and stroke team clinical notes. Results Of 1328 patients included (mean age, 73 years; 43% female), the proportion of patients with centrally read symptomatic ICAD was 14%, of whom 39% were diagnosed by the stroke clinical team and 65% by the reporting radiologist. Patients of Asian ethnicity more commonly had symptomatic ICAD than patients of European ethnicity (21% versus 14%; odds ratio, 1.5 [95% CI, 1.0–2.23]). Conclusion Intracranial atherosclerosis is common and underdiagnosed in an Australian tertiary stroke care unit setting in patients from multiple ethnic backgrounds. |
| format | Article |
| id | doaj-art-c87eab9f2abf4755aadeee7c25832eac |
| institution | OA Journals |
| issn | 2694-5746 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-c87eab9f2abf4755aadeee7c25832eac2025-08-20T02:37:33ZengWileyStroke: Vascular and Interventional Neurology2694-57462025-01-015110.1161/SVIN.124.001397Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic GroupsDavor Pavlin‐Premrl0Michael Waters1Vincent Thijs2Peter J. Mitchell3Nawaf Yassi4Mark W. Parsons5Louise Weir6Lauren Pesavento7Julian Maingard8Geoffrey Cloud9Vimal Stanislaus10Mei Ngun11Bruce C.V. Campbell12Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville AustraliaDepartment of Neurology Royal Adelaide Hospital Adelaide AustraliaDepartment of Neurology Austin Hospital Heidelberg AustraliaDepartment of Radiology Royal Melbourne Hospital University of Melbourne Parkville AustraliaDepartment of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville AustraliaDepartment of Neurology Liverpool Hospital University of New South Wales Sydney AustraliaDepartment of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville AustraliaDepartment of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville AustraliaDepartment of Radiology Austin Hospital Heidelberg AustraliaDepartment of Neurology Alfred Hospital Melbourne AustraliaDepartment of Neurology Alfred Hospital Melbourne AustraliaDepartment of Neurology Austin Hospital Heidelberg AustraliaDepartment of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville AustraliaBackground Intracranial atherosclerosis (ICAD) is a common cause of stroke globally. We calculated the proportion of patients with stroke with symptomatic intracranial atherosclerosis in an Australian multiethnic setting, as well as diagnostic rates by stroke physicians and radiologists. Methods This was a multicenter retrospective cohort study based in Melbourne, Australia. Demographic data (including self‐reported ethnicity) and data on vascular risk factors were collected. Symptomatic ICAD was independently identified by 2 blinded stroke neurologists using multiplanar reformats and maximum intensity projections of routinely acquired thin slice computed tomography angiography data, with disagreements resolved by a third blinded stroke neurologist. This diagnostic reference standard was compared to the proportion of patients with ICAD identified in the radiology report and stroke team clinical notes. Results Of 1328 patients included (mean age, 73 years; 43% female), the proportion of patients with centrally read symptomatic ICAD was 14%, of whom 39% were diagnosed by the stroke clinical team and 65% by the reporting radiologist. Patients of Asian ethnicity more commonly had symptomatic ICAD than patients of European ethnicity (21% versus 14%; odds ratio, 1.5 [95% CI, 1.0–2.23]). Conclusion Intracranial atherosclerosis is common and underdiagnosed in an Australian tertiary stroke care unit setting in patients from multiple ethnic backgrounds.https://www.ahajournals.org/doi/10.1161/SVIN.124.001397diagnosisepidemiologyethnologyintracranial atherosclerosis |
| spellingShingle | Davor Pavlin‐Premrl Michael Waters Vincent Thijs Peter J. Mitchell Nawaf Yassi Mark W. Parsons Louise Weir Lauren Pesavento Julian Maingard Geoffrey Cloud Vimal Stanislaus Mei Ngun Bruce C.V. Campbell Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups Stroke: Vascular and Interventional Neurology diagnosis epidemiology ethnology intracranial atherosclerosis |
| title | Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups |
| title_full | Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups |
| title_fullStr | Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups |
| title_full_unstemmed | Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups |
| title_short | Symptomatic Intracranial Atherosclerosis in an Australian Context: Common and Underdiagnosed in Multiple Ethnic Groups |
| title_sort | symptomatic intracranial atherosclerosis in an australian context common and underdiagnosed in multiple ethnic groups |
| topic | diagnosis epidemiology ethnology intracranial atherosclerosis |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.124.001397 |
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