Evidence map›Paper›PMID 39956813›Full record

ArticleAnnals of Indian Academy of Neurology2025

Derivation of a CT Angiography-Based Arch Atherosclerosis Grading in Cryptogenic Ischemic Stroke.

Ankur Wadhwa, Ravinder-Jeet Singh, Mohammed Almekhlafi, Bijoy K Menon, Poornima N Nambiar, Arun Kathuveetil, Santhosh Kannath, Manik Chhabra, P N Sylaja, Andrew M Demchuk and 1 more

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Article in Annals of Indian Academy of Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

11 authors.

Ankur WadhwaFellow Canadian Stroke Consortium, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada.
Ravinder-Jeet SinghNorthern Ontario School of Medicine University, Sudbury, Ontario, Canada.
Mohammed AlmekhlafiDepartment of Clinical Neuroscience, Radiology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Bijoy K MenonDepartment of Clinical Neuroscience, Radiology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Poornima N NambiarDepartment of Neurology, Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram, Kerala, India.
Arun KathuveetilDepartment of Neurology, Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram, Kerala, India.
Santhosh KannathDepartment of Neurology, Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram, Kerala, India.
Manik ChhabraDepartment of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada.
P N SylajaDepartment of Neurology, Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram, Kerala, India.
Andrew M DemchukDepartment of Clinical Neuroscience, Radiology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Simerpreet BalDepartment of Neurology, Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram, Kerala, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesWe aimed to develop a novel computed tomography angiography (CTA)-based grading system to quantify the severity of aortic arch disease and compare the detection of aortic arch atherosclerosis (AAAthero) on routinely acquired arch-to-vertex CTA against transesophageal echocardiogram (TEE) among patients with cryptogenic ischemic stroke.

methodsA systematic literature review was conducted to develop a computed tomography (CT)-based AAAthero grading system. CTA was compared against TEE for detecting AAAthero. The severity of arch atherosclerosis was scored based on a 5-point grading system. Patients with cryptogenic stroke who underwent both CTA and TEE were included in the derivation cohort to assess the sensitivity and specificity of CTA compared to TEE. The CT-based grading system for aortic plaques was then applied to an independent cohort of patients with cryptogenic stroke.

resultsThree studies were identified in a systematic review, and 141 patients were included in the derivation cohort. AAAthero was detected in 29 patients (20.6%) and 28 patients (19.9%) on TEE and CTA, respectively. The sensitivity of CTA to detect any atherosclerosis was 76%, which increased to 100% to detect moderate to severe disease. The specificity was 95% for any atherosclerosis and 100% for moderate to severe arch disease. Seven patients with AAAthero on TEE had normal CTA, but mild arch disease. Meanwhile, six patients with CTA and negative TEE had plaques on the arch's transverse segment.

conclusionsRoutinely acquired arch-to-vertex CTA provides an accurate, noninvasive alternative to TEE for detecting AAAthero, especially in clinically relevant moderate to severe arch disease.

Identifiers

PMID39956813
PMCPMC11892953

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