Impact of MCA stenosis on the early outcome in acute ischemic stroke patients

Jiann Shing Jeng, Fang I. Hsieh, Hsu Ling Yeh, Wei Hung Chen, Hou Chang Chiu, Sung Chun Tang, Chung Hsiang Liu, Huey Juan Lin, Shih Pin Hsu, Yuk Keung Lo, Lung Chan, Chih Hung Chen, Ruey Tay Lin, Yu Wei Chen, Jiunn Tay Lee, Chung Hsin Yeh, Ming Hui Sun, Ta Chang Lai, Yu Sun, Mu Chien SunPo Lin Chen, Tsuey Ru Chiang, Shinn Kuang Lin, Bak Sau Yip, Chin I. Chen, Chi Huey Bai, Sien Tsong Chen, Hung Yi Chiou, Li Ming Lien, Chung Y. Hsu

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background: Asians have higher frequency of intracranial arterial stenosis. The present study aimed to compare the clinical features and outcomes of ischemic stroke patients with and without middle cerebral artery (MCA) stenosis, assessed by transcranial sonography (TCS), based on the Taiwan Stroke Registry (TSR). Methods: Patients with acute ischemic stroke or transient ischemic attack registered in the TSR, and received both carotid duplex and TCS assessment were categorized into those with stenosis (≥50%) and without (<50%) in the extracranial internal carotid artery (ICA) and MCA, respectively. Logistic regression analysis, Kaplan-Meier method and Cox proportional hazard model were applied to assess relevant variables between groups. Results: Of 6003 patients, 23.3% had MCA stenosis, 10.1% ICA stenosis, and 3.9% both MCA and ICA stenosis. Patients with MCA stenosis had greater initial NIHSS, higher likelihood of stroke-in-evolution, and more severe disability than those without (all p<0.001). Patients with MCA stenosis had higher prevalence of hypertension, diabetes and hypercholesterol-emia. Patients with combined MCA and extracranial ICA stenosis had even higher NIHSS, worse functional outcome, higher risk of stroke recurrence or death (hazard ratio, 2.204; 95% confidence intervals, 1.440-3.374; p<0.001) at 3 months after stroke than those without MCA stenosis. Conclusions: In conclusion, MCA stenosis was more prevalent than extracranial ICA stenosis in ischemic stroke patients in Taiwan. Patients with MCA stenosis, especially combined extracranial ICA stenosis, had more severe neurological deficit and worse outcome.

Original languageEnglish
Article numbere0175434
JournalPLoS One
Issue number4
Publication statusPublished - Apr 1 2017

ASJC Scopus subject areas

  • General Medicine
  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences


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