Intracranial atherosclerosis: Cerebral angiography f indings, clinical phenotypes, and associated risk factors in a retrospective study

Background and aim: Intracranial atherosclerosis (ICAS) is a significant contributor to global stroke incidence and is associated with a substantially higher risk of stroke recurrence compared to other stroke types. The annual recurrence rate of ischemic stroke in ICAS ranges from 10% to 50%, with a two-year recurrence rate of 38.2% in the affected arterial territory. Identifying the risk factors associated with ICAS is essential to improving prevention and management strategies. Methods: This retrospective descriptive study analyzed medical records of ischemic stroke patients at Wahidin Sudirohusodo Hospital who underwent cerebral angiography from January 2021 to December 2022. Variables studied included demographic characteristics (age, sex), risk factors, and the location of ICAS within intracranial vessels. Results: A total of 106 ICAS patients were identified during the study period. The majority were male (58.40%), with an average age of 54.7 years. The highest prevalence was observed in the 50–60 age group (45.28%). Hypertension was the most frequent risk factor (70.75%), followed by dyslipidemia (46.22%), diabetes mellitus (22.64%), prior stroke or transient ischemic attack (17.92%), extracranial carotid artery stenosis (7.54%), and cardiac disease (5.66%). The middle cerebral artery (MCA) was the most commonly affected site (57.46%). Conclusions: Hypertension and dyslipidemia were the leading modifiable risk factors for ICAS, emphasizing the need for targeted management strategies. Effective control of these conditions could serve as a primary and secondary
preventive approach to reduce ICAS incidence and associated complications. (www.actabiomedica.it) Key words: intracranial atherosclerosis, large artery disease, ischemic stroke, hypertension, dyslipidemia, cerebral angiography, risk factors, clinical phenotypes, retrospective cohort study