====== Carotid artery calcification ======

[[Intracranial atherosclerosis]] related [[large vessel occlusion]]s (ICAS-O) are challenging to diagnose and manage. The degree of [[intracranial]] [[carotid artery calcification]] may assist pre-[[thrombectomy]] diagnosis of ICAS and guide treatment strategy. 

The aim of a study of Tsang et al. from the Division of Neurosurgery, Division of Neurology, Department of Diagnostic Radiology, Queen Mary Hospital, The University of [[Hong Kong]] was to determine if intracranial carotid calcification is associated with ICAS-O.

Consecutive large vessel occlusion patients who underwent thrombectomy from 2006 to 2017 were retrospectively studied. Patients were classified into ICAS-O if pre-existing atherosclerotic lesion was identified as the etiology for large vessel occlusion during the thrombectomy. The degree of intracranial carotid artery calcification (ICAC), technical and clinical outcomes of ICAS-O was compared with non-ICAS-O patients.

In a retrospective cohort study of 64 thrombectomy patients, ICAS-O accounted for 14.1% of cases and was associated with higher degree of carotid calcification (mean Woodcock scale 2.8 vs 1.6, p = 0.044), need of stent-retreiver rescue (55.6% vs 5.5%, p = 0.001), and adjuvant stenting or angioplasty (33.3% vs 0%, p = 0.002) compared with non-ICAS-O.

The severity of ICAC may be associated with ICAS-O as the underlying etiology amongst thrombectomy patients. Compared with large vessel occlusion of other causes, ICAS-O was associated with more failure of aspiration and a higher need of adjuvant stenting and angioplasty
((Tsang ACO, Lau KK, Tsang FCP, Tse MMY, Lee R, Lui WM. Severity of intracranial
carotid artery calcification in intracranial atherosclerosis-related occlusion
treated with endovascular thrombectomy. Clin Neurol Neurosurg. 2018 Sep
24;174:214-216. doi: 10.1016/j.clineuro.2018.09.030. [Epub ahead of print] PubMed
PMID: 30278297.
)).