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  • [1]Fischer U, Baumgartner A, Arnold M, Nedeltchev K, Gralla J, Marco De Marchis G, et al. What is a minor stroke? Stroke. 2010; 41: 661–666. https://doi.org/10.1161/STROKEAHA.109.572883.

  • [2]Leng X, Wang D. Editorial: minor stroke is not minor. Stroke and Vascular Neurology. 2023; 8: 175–177. https://doi.org/10.1136/svn-2022-002049.

  • [3]Xue R, Zhong W, Zhou Y, He Y, Yan S, Chen Z, et al. Endovascular treatment for minor acute ischemic strokes with large vessel occlusion. Journal of the American Heart Association. 2022; 11: e027326. https://doi.org/10.1161/JAHA.122.027326.

  • [4]Lin C-H, Saver JL, Ovbiagele B, Tang S-C, Lee M, Liebeskind DS. Effects of endovascular therapy for mild stroke due to proximal or M2 occlusions: meta-analysis. Journal of Neurointerventional Surgery. 2023; 15: 350–354. https://doi.org/10.1136/neurintsurg-2022-018662.

  • [5]Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke. 2019; 50: e344–e418. https://doi.org/10.1161/STR.0000000000000211.

  • [6]López-Rueda A, Ibáñez Sanz L, Alonso de Leciñana M, de Araújo Martins-Romeo D, Vicente Bartulos A, Castellanos Rodrigo M, et al. Recommendations on the use of computed tomography in the stroke code: Consensus document SENR, SERAU, GEECV-SEN, SERAM. Radiologia (Engl Ed). 2023; 65: 180–191. https://doi.org/10.1016/j.rxeng.2022.11.006.

  • [7]Arboix A, Álvarez-Sabin J, Soler L. En nombre del Comité de redacción ad hoc del grupo de estudio de enfermedades cerebrovasculares de la SEN. Ictus. Clasificación y criterios diagnósticos. Neurologia (Barcelona, Spain). 1998; 13: S3–S10. (In Spanish)

  • [8]Ros Arlanzón P, Aledo Sala C, Hernández Lorido R, Beltrán Blasco I, López Hernández N. Analysis of real-time data gathered using a mobile application from patients treated after code stroke activation in Alicante. Neurology Perspectives. 2024; 4: 100156. https://doi.org/10.1016/j.neurop.2024.100156.

  • [9]Arboix A, Massons J, García-Eroles L, Targa C, Comes E, Parra O. Clinical predictors of lacunar syndrome not due to lacunar infarction. BioMed Central Neurology. 2010; 10: 31. https://doi.org/10.1186/1471-2377-10-31.

  • [10]Saber H, Khatibi K, Szeder V, Tateshima S, Colby GP, Nour M, et al. Reperfusion Therapy Frequency and Outcomes in Mild Ischemic Stroke in the United States. Stroke. 2020; 51: 3241–3249. https://doi.org/10.1161/STROKEAHA.120.030898.

  • [11]Pérez Sánchez S, Barragán Prieto A, Sánchez Miura JA, Domínguez Mayoral AM, De Torres Chacón R, Gamero García MÁ, et al. Retraso en la administración de tratamiento trombolítico en el ictus minor. Revista de Neurologia. 2021; 72: 352–356. (In Spanish) https://doi.org/10.33588/rn.7210.2020510.

  • [12]Volbers B, Gröger R, Engelhorn T, Marsch A, Macha K, Schwab S, et al. Acute stroke with large vessel occlusion and minor clinical deficits: prognostic factors and therapeutic implications. Frontiers in Neurology. 2021; 12: 736795. https://doi.org/10.3389/fneur.2021.736795.

  • [13]Duloquin G, Crespy V, Jakubina P, Giroud M, Vergely C, Béjot Y. Large vessel occlusion in patients with minor ischemic stroke in a population-based study. The Dijon Stroke Registry. Frontiers in Neurology. 2022; 12: 796046. https://doi.org/10.3389/fneur.2021.796046.

  • [14]Lu Z, Xiong Y, Yang K, Gu H, Duan C, Zhao X, et al. What predicts large vessel occlusion in mild stroke patients? BioMed Central Neurology. 2023; 23: 29. https://doi.org/10.1186/s12883-022-03020-6.

  • [15]Zhong W, Zhou Y, Zhang K, Yan S, Sun J, Lou M. Minor non-disabling stroke patients with large vessel severe stenosis or occlusion might benefit from thrombolysis. brain sciences. 2021; 11: 945. https://doi.org/10.3390/brainsci11070945.

  • [16]Broccolini A, Brunetti V, Colò F, Alexandre AM, Valente I, Falcou A, et al. Early neurological deterioration in patients with minor stroke due to isolated M2 occlusion undergoing medical management: a retrospective multicenter study. Journal of Neurointerventional Surgery. 2023; 16: 38–44. https://doi.org/10.1136/jnis-2023-020118.

  • [17]Seners P, Ben Hassen W, Lapergue B, Arquizan C, Heldner MR, Henon H, et al. Prediction of early neurological deterioration in individuals with minor stroke and large vessel occlusion intended for intravenous thrombolysis alone. Journal of the American College of Cardiology Neurol. 2021; 78: 321. https://doi.org/10.1001/jamaneurol.2020.4557.

  • [18]Arquizan C, Lapergue B, Gory B, Labreuche J, Henon H, Albucher J-F, et al. Evaluation of acute mechanical revascularization in minor stroke (NIHSS score ≤5) and large vessel occlusion: The MOSTE multicenter, randomized, clinical trial protocol. International Journal of Stroke: Official Journal of the International Stroke Society. 2023; 18: 1255–1259. https://doi.org/10.1177/17474930231186039.

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Open Access 3 Apr 2025Original Article
EnglishSpanish
Multicenter Study on the Frequency of Large Vessel Occlusion in Patients with Minor Stroke
Pablo Ros-Arlanzón 1,2,*, Diego Corona García 1,2, Raquel Hernández Lorido 1,2, Isabel Beltrán Blasco 1,2, José Tembl Ferrairo 3, Cristina Soriano Soriano 4, Nicolás López Hernández 1,2
Affiliations
Article Info

1 Departamento de Neurología, Hospital General Universitario Dr. Balmis, 03010 Alicante, España

2 Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, España

3 Departamento de Neurología, Hospital Universitario y Politécnico La Fe, 46026 Valencia, España

4 Departamento de Neurología, Hospital General de Castellón, 12004 Castellón, España

*Correspondence: ros_pabarl@gva.es (Pablo Ros-Arlanzón)

Abstract

Background:

The management of minor ischemic stroke presents significant challenges due to variability in the applicationof neuroimaging protocols and endovascular treatment (EVT). The lack of consensus on the need for computed tomographyangiography (CTA) in these cases highlights the importance of investigating the prevalence and clinical implications oflarge vessel occlusion (LVO) in this population.
Methods:

Analysis of the multicenter CODICT registry in patientswith minor ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) score ≤5) treated at tertiary stroke alert(SA) centers in the Valencian Community between July 1, 2020 and November 30, 2023. The frequency of LVO, definedas occlusions in the internal carotid artery, vertebral artery, basilar artery, and critical segments of the middle (M1, M2),anterior (A1, A2), and posterior (P1, P2) cerebral arteries, was evaluated using CTA
Results:

A total of 5473 SA activationswere identified during the study period. A total of 833 patients suffered a minor ischemic stroke. LVO was observed in17.5% (n = 146) of minor strokes on CTA. EVT was performed in 48.6% (n = 71) of patients with minor stroke and LVO.The most frequently occluded vessels were the middle cerebral artery (MCA) in its M1 and M2 segments, both in 35.6%(n = 52) of cases. However, the vessels most frequently treated with EVT were in the M1, in 29.5% (n = 43) of cases,followed by the M2, in 10.9% (n = 16) of cases.
Conclusions:

This study highlights the importance of performing CTAin all patients who meet SA activation criteria, regardless of clinical severity. The presence of LVO changed the clinicalmanagement in almost half of the patients with minor stroke and LVO.

Keywords

  • stroke
  • minor stroke
  • computed tomography angiography
  • large vessel occlusion

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