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

Abstract

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.