Association Between Net Vertebral Artery Flow Volume and Non-AF Stroke: A Retrospective 2-Year Analysis

• Published in: Frontiers in neurology Vol. 9; p. 1198
• Main Authors: Lee, Hsun-Hua, Huang, Li-Kai, Chang, Hwai-Jan, Wu, Dean, Chi, Nai-Fang, Chan, Lung, Hu, Chaur-Jong, Chen, Chih-Chung
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 18.01.2019
• Subjects: anterior circulation infarction; DWI; flow volume; Neurology; posterior circulation infarction; sonography; stroke subtypes; flow volume; anterior circulation infarction; posterior circulation infarction; stroke subtypes; sonography; DWI
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2018.01198

Association between net vertebral artery flow volume (NVAFV) and stroke types remains unclear. We hypothesize NVAFV is low in patients with posterior circulation infarction (PCI) and an ideal cut-off value for discriminating PCI from anterior circulation infarction (ACI) and controls may be present. As study candidates, we retrospectively enrolled hospitalized patients with first-time non-AF stroke within 2-years period. Consecutive non-AF, non-stroke subjects were enrolled as the control group. We compared NVAFV values among the PCI, ACI, and control groups. Overall, 866 candidates-213, 418, and 235 candidates in the PCI, ACI, and control groups, respectively-were enrolled. NVAFV (mean ± SD) values were 134.8 ± 52.7, 152.3 ± 59.2, and 172.0 ± 54.7 mL/min in the PCI, ACI, and control groups, respectively. Statistics revealed significant difference ( < 0.001) among three groups. To use NVAFV as a diagnostic parameter, the AUC of any two groups should be between 0.58 and 0.69. Most (93.6%) of the controls had NVAFV above 100 mL/min. The odds ratio of any non-AF stroke is 3.48 if the NVAFV is below 100 mL/min. NVAFV is lowest in non-AF PCI group. Low NVAFV is associated with both non-AF ACI and PCI. No ideal cut-off value is available to discriminate PCI from other two conditions. We agree that an NVAFV of 100 mL/min is the lower limit of a normal value. Any value below 100 mL/min indicates high stroke risk and implies diffuse cerebral atherosclerosis and impaired cerebral perfusion.