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33 results on '"Wong, Lawrence Ka Sing"'

6. The correlation between intracranial arterial calcification and the outcome of reperfusion therapy

Author

Du, Heng, Zheng, Jianrong, Li, Xuelong, Bos, Daniel, Yang, Wenjie, Cheng, Yajing, Liu, Cong, Wong, Lawrence Ka Sing, Hu, Jun, Chen, Xiangyan, Du, Heng, Zheng, Jianrong, Li, Xuelong, Bos, Daniel, Yang, Wenjie, Cheng, Yajing, Liu, Cong, Wong, Lawrence Ka Sing, Hu, Jun, and Chen, Xiangyan

Abstract

Objective: Intracranial arterial calcification (IAC) is a risk factor of ischemic stroke. However, the relationship between IAC patterns and clinical outcome of ischemic stroke remains controversial. We aimed to investigate the correlation between IAC patterns and the effects of reperfusion therapy among acute stroke patients. Methods: Consecutive acute ischemic stroke patients who underwent reperfusion therapy were included. IAC was categorized as intimal or medial. Based on its involvement, IAC was further classified as diffuse or focal. Neurologic dysfunction was assessed by the National Institute of Health stroke scale (NIHSS). Clinical outcome including favorable neurologic outcome (FNO) and early neurologic deterioration (END) were assessed. Results: Of 130 patients, 117 had IAC. Intimal IAC was identified in 74.6% of patients and medial IAC was present in 64.6% of patients. Diffuse IAC was present in 31.5% of patients. All diffuse IACs were medial pattern. Diffuse IAC was associated with higher baseline NIHSS (p = 0.011) and less FNO (p = 0.047). Compared with patients with focal or single diffuse IAC, patients with multiple diffuse IAC had higher baseline NIHSS (p = 0.002) and less FNO (p = 0.024). Multivariable linear regression (p < 0.001) and logistic regression (p = 0.027) suggested that multiple diffuse IAC was associated with higher baseline NIHSS and less FNO. No significant association was found between END and different IAC patterns. Interpretation: Multiple diffuse medial IAC may predict severer neurologic dysfunction and less favorable neurologic outcome after reperfusion therapy in acute stroke patients.

Published
2023

10. Intracranial Arterial Calcification and Intracranial Atherosclerosis:Close but Different

Author

Du, Heng, Li, Jia, Yang, Wenjie, Bos, Daniel, Zheng, Lu, Wong, Lawrence Ka Sing, Leung, Thomas W., Chen, Xiangyan, Du, Heng, Li, Jia, Yang, Wenjie, Bos, Daniel, Zheng, Lu, Wong, Lawrence Ka Sing, Leung, Thomas W., and Chen, Xiangyan

Abstract

Background and Purpose: Intracranial arterial calcification (IAC) may be present in the intimal or medial arterial layer. This study aimed to elucidate the link between the calcification and atherosclerotic disease in the intracranial vasculature. Methods: Consecutive patients with acute ischemic stroke were included. Bilateral intracranial segment of the internal carotid artery, M1 segment of the middle cerebral artery, intracranial segment of the vertebral artery, and the basilar artery were visualized by the multi-detector computed tomography (CT) and vessel-wall magnetic resonance imaging (vwMRI) within 14 days after stroke onset. IAC was into the intimal or medial pattern. Subsequently, on the vwMRI, we assessed the luminal stenosis, eccentricity, plaque burden, and intraplaque hemorrhage (IPH) as markers of atherosclerosis at each IAC site. Results: Among 69 patients with stroke, IAC was identified in 35% of (161/483) artery segments, of which 61.5% were predominantly intimal calcification and 38.5% were predominantly medial calcification. About 79.8% of intimal calcifications and 64.5% of medial calcifications co-existed with atherosclerotic plaques. Intimal calcification was associated with luminal stenosis (p = 0.003) caused by atherosclerotic lesions. Compared with the medial IAC, intimal IAC was more often accompanied by eccentric plaques (p = 0.02), larger plaque burden (p = 0.001), and IPH (p = 0.001). Conclusion: Our multimodal imaging-based comparison study on intracranial arteriosclerosis demonstrated that intimal IAC, compared with medial IAC, was more often accompanied by the luminal stenosis, larger plaque burden, eccentricity, and IPH, providing strong evidence for clinical evaluation on the mechanism, risk, and prognosis of ischemic stroke.

Published
2022

15. Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging

Author

Yang, Wen-Jie, primary, Wasserman, Bruce A., additional, Zheng, Lu, additional, Huang, Zhong-Qing, additional, Li, Jia, additional, Abrigo, Jill, additional, Wong, Simon Sin-man, additional, Ying, Michael Tin-cheung, additional, Chu, Winnie Chiu-Wing, additional, Wong, Lawrence Ka-sing, additional, Leung, Thomas Wai-Hong, additional, and Chen, Xiang-Yan, additional

Published
2021
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20. Dabigatran or Aspirin in East Asian Patients With Embolic Stroke of Undetermined Source: RE-SPECT ESUS Subgroup Analysis.

Author

Shinichiro Uchiyama, Kazunori Toyoda, Byung-Chul Lee, Chia-Wei Liou, Ka Sing Wong, Lawrence, Grauer, Claudia, Brueckmann, Martina, Atsushi Taniguchi, Yasuhisa Urano, Easton, J. Donald, Uchiyama, Shinichiro, Toyoda, Kazunori, Lee, Byung-Chul, Liou, Chia-Wei, Wong, Lawrence Ka Sing, Taniguchi, Atsushi, Urano, Yasuhisa, and RE-SPECT ESUS Investigators

Published
2021
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33. Angioplasty and stenting for intracranial atherosclerotic stenosis with nitinol stent: factors affecting technical success and patient safety.

Author

Yu SC, Leung TW, Hung EH, Lee KT, and Wong LK

Subjects
Aged, Angioplasty mortality, Angioplasty, Balloon instrumentation, Angioplasty, Balloon methods, Angioplasty, Balloon mortality, Cerebral Arteries abnormalities, Cerebral Arteries diagnostic imaging, Cerebral Arteries pathology, Constriction, Pathologic diagnostic imaging, Constriction, Pathologic pathology, Equipment Failure, Female, Humans, Intracranial Arteriosclerosis diagnostic imaging, Intracranial Arteriosclerosis pathology, Male, Middle Aged, Postoperative Complications etiology, Process Assessment, Health Care methods, Prospective Studies, Radiography, Stents adverse effects, Treatment Outcome, Alloys therapeutic use, Angioplasty instrumentation, Angioplasty methods, Constriction, Pathologic therapy, Intracranial Arteriosclerosis therapy, Patient Safety, Postoperative Complications epidemiology, Stents standards
Abstract

Background: Angioplasty and stenting using nitinol stents is a recognized treatment option for intracranial atherosclerosis., Objective: To identify procedure-related factors that may affect patient safety and technical outcome., Methods: In this prospective study of 57 consecutive patients, the primary end points were intraprocedural technical problems, periprocedure morbidity, and complications. Major periprocedure complication was defined as all stroke or death at 30 days. Technical failure was defined as the inability to complete the procedure because of technical or safety problems. Procedure failure was defined as a procedure outcome of technical failure or major periprocedure complication. Secondary end points were procedure-related factors that may affect patient safety and technical outcome., Results: Procedure failure rate was 12.3% (7/57) (major periprocedure complication rate, 5.3% [3/57]; technical failure rate, 7% [4/57]). Initial failure in tracking of balloon or stent occurred in 20 patients, other technical problems occurred in 11 patients, including kinking or trapping of balloon catheter (2 cases), difficulty in unsheathing of stent (3 cases), forward migration of stent during deployment (4 cases), trapping of nose cone after stent deployment (1 case), fracture of delivery system (2 cases), and guidewire fracture (1 case). Unfavorable vascular morphology signified by the presence of 2 or more reverse curves along the access path was found to associate with initial failure in the tracking of instruments (OR = ∞), and occurrence of other technical problems (OR = 25)., Conclusion: Procedure-related factors could be identified and lead to improvements in patient safety and technical outcome. Tortuous vascular morphology is a key factor to be overcome.

Published
2012
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