Aortic arch calcification, procedural times, and outcomes of endovascular treatment in patients with acute ischemic stroke.

OBJECTIVE To determine the frequency of aortic arch calcification and it's relationship with procedural times, angiographic recanalization, and discharge outcomes in acute ischemic stroke patients undergoing endovascular treatment. METHODS The thoracic component of computed tomographic (CT) angiogram were reviewed by an independent reviewer to determine presence of any calcification; and the severity of calcification was graded as follows: mild, single small calcifications; moderate, multiple small calcifications; or severe, one or more large calcifications. RESULTS Aortic arch calcification was present in 120 (62.4%) of 188 patients and severity was graded as mild (n=24), moderate (n=44), and severe (n=52). Compared with patients without calcification, the mean intracranial access time (minutes ± SD) was similar among patients with aortic arch calcification (70 ± 31 versus 64 ± 31, p=0.9). The mean time intracranial access time increased with increasing severity of aortic arch calcification (61±27, 67±29, and 74±34, p=0.3). Patients with aortic arch calcification had similar rates of complete or partial recanalization [85 (71%) versus 50 (76%)], p=0.6) but lower rates of favorable outcomes [modified Rankin scale 0-2] at discharge 27 (22%) versus 26 (39%), p=0.02). CONCLUSIONS A high proportion of acute ischemic stroke patients have aortic arch calcification which is associated with lower rates of favorable outcome following endovascular treatment. ABBREVIATIONS SDstandard deviationICHintracerebral hemorrhageNIHSSNational Institutes of Health Stroke ScaleTIAtransient ischemic attackICHintracerebral hemorrhagemRSmodified Rankin scale.