The Frequency and Associated Factors of Asymmetrical Prominent Veins: A Predictor of Unfavorable Outcomes in Patients with Acute Ischemic Stroke

Neural Plasticity, 2021 · DOI: https://doi.org/10.1155/2021/9733926 · Published: September 17, 2021

Simple Explanation

This study investigates asymmetrical prominent veins (APV) in acute ischemic stroke (AIS) patients using susceptibility-weighted imaging (SWI). APV includes asymmetrical prominent cortical veins (APCV) and asymmetrical deep medullary veins (ADMV). The presence of APV is associated with the prognosis of AIS patients. The study defines APV as veins in the ischemic hemisphere being larger or more numerous than those on the contralateral side. APV is linked to increased deoxyhemoglobin, related to reduced oxygen saturation. The ischemic area with APV may represent the penumbra in ischemic stroke. The research aims to assess the frequency and factors associated with APV in AIS patients. It found that the frequency of APV ≥10 mL is high in patients with AIS within 12 hours of symptom onset. History of atrial fibrillation and severe proximal artery stenosis or occlusion are strong predictors of high APV.

Study Duration

Between January 2013 and December 2017

Participants

76 patients with acute ischemic stroke

Evidence Level

Not specified

Key Findings

1
The frequency of high APV (volume ≥10 mL) was 46.05% in patients with AIS within 12 hours of symptom onset.
2
History of atrial fibrillation (AF) was identified as an independent factor significantly associated with high APV.
3
Severe proximal artery stenosis or occlusion (≥50%) was also found to be an independent factor associated with high APV.

Research Summary

This study aimed to determine the frequency and associated risk factors of asymmetrical prominent veins (APV) in patients with acute ischemic stroke (AIS) within 12 hours of symptom onset. The study found that the frequency of high APV (volume ≥10 mL) was 46.05%. Furthermore, history of atrial fibrillation (AF) and severe proximal artery stenosis or occlusion were identified as independent factors associated with high APV. The researchers concluded that history of atrial fibrillation and proximal artery stenosis or occlusion (≥50%) are strong predictors of asymmetrical prominent veins observed on SWI maps of AIS patients within 12 hours of symptom onset.

Practical Implications

Diagnostic Tool

APV on SWI can be used as an early diagnostic marker in AIS patients.

Risk Stratification

Patients with AF and severe arterial stenosis are at higher risk of developing high APV.

Prognostic Indicator

APV volume can serve as a predictor of unfavorable outcomes in AIS patients.

Study Limitations

1
Cross-sectional study design limits the establishment of direct causality.
2
Relatively small sample size (n=76) may limit the generalizability of the findings.
3
Lack of follow-up results to determine the progression or disappearance of APV after initial imaging.

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