The clinical characteristics and predictors of patients with ischemic stroke caused by spontaneous internal carotid artery dissection

Abstract Background: Few studies have examined the clinical characteristics and predictors of ischemic stroke caused by spontaneous internal carotid artery dissection (sICAD). This study aimed to investigate the clinical characteristics and predictors of patients with ischemic stroke caused by sICAD to provide clinical guidance and a basis for treatment. Methods: Clinical characteristics, outcomes, and predictors were investigated in consecutive patients with ischemic stroke caused by sICAD between January 2018 and January 2022 at Three Grade III Class A general public hospitals in southwest China. We screened 102 patients with ischemic stroke caused by ICAD for follow-up, of which 11 were lost to follow-up. Results: Of the 91 patients included in this study, 84 had unilateral and seven had bilateral stroke, with a mean follow-up modified Rankin Scale (mRS) score of 1(0-3). Sixty-six (72.5%) of the 91 patients had mRS scores of 0-2. On multivariate analysis, low baseline National Institutes of Health Stroke Scale (NIHSS) scores (P ＜ 0.01; odds ratio [OR]: 1.39; 95% confidence interval [CI]: 1.12–1.73) and endovascular stenting (P ＜ 0.01; OR: 0.10; 95% CI: 0.02–0.50) were independent predictors of a favorable clinical outcome. Receiver operating characteristic (ROC) analysis showed an area under the curve of 0.94. Conclusions: Favorable outcomes were observed in majority of patients with ischemic stroke caused by sICAD. Additionally, lower NIHSS scores and stent implantation were independent predictors of favorable outcomes.