Citations 2
Characteristics of patients with extracranial cervical artery dissections involving more than a single vessels: A subgroup analysis of STOP-CAD
Metanis, Issa, Akpokiere, Favour , Shu, Liqi , Jubran, Hamza , Antonenko, Kateryna, Rosa, Sara, Soares, Mafalda Delgado, Engelter, Stefan T. , Traenka, Christopher Kenan, Marto, João Pedro, Romoli, Michele, Zubair, Adeel , Omran, Setareh Salehi , Jubeh, Tamer , Shalabi, Fatma , Khan, Muhib, DeSousa, Diana Aguiar, Yaghi, Shadi, Leker, Ronen R., Sousa, Diana Aguiar de , Soares, Mafalda , Rosa, Sara , Jubran, Hamza , Engelter, Stefan T , Kaufman, Josefin E , Marto, João Pedro , Keser, Zafer , Aguiar de Sousa, Diana , Leker, Ronen R , Soares, Mafalda , Rosa, Sara , Metanis, Issa , Schwartzmann, Yoel , Antonenko, Kateryna , Heldner, Mirjam R. , Kaufmann, Josefin E. , Romoli, Michele , Keser, Zafer , Khan, Muhib , Yaghi, Shadi
European Stroke Journal | January 20, 2026 | Volume: 11 | Issue: 1 | Pages: No page available
Abstract Introduction Cervical arterial dissections (CeAD) can involve either single (sCeAD) or multiple (mCeAD) arteries. Whether the involvement of a single versus multiple arteries is associated with outcomes remains unclear. We aimed to study associations between the number of affected arteries and clinical, imaging and outcome parameters. Patients and methods Patients with CeAD from the STOP-CAD multicenter registry study were included. Clinical, imaging, treatment and outcome parameters were compared between patients with sCeAD and mCeAD. Regression analyses were performed to identify associations with multi-arteries involvement. Results Overall, 3858 STOP-CAD patients were included in this analysis and 443 (11.5%) had mCeAD. The presence of mCeAD was associated with age (adjusted odds ratio [aOR] 95% confidence intervals [95% CI] 0.99; (0.98–1.00)), female sex (aOR 1.5; 95% CI 1.17–1.91), recent upper respiratory infection (aOR 2.25; 95% CI 1.55–3.27), presence of connective tissue disease (aOR 3.11; 95% CI 2.32–4.17), severe arterial stenosis (aOR 1.95; 95% CI 1.95–2.58), intracranial extension (aOR 1.47; 95% CI 1.04–2.09), vertebral artery involvement (aOR 2.50; 95% CI 1.94–3.22) and presence of dissecting aneurysm (aOR 2.59; 95% CI 1.95–3.42). In adjusted analyses, mCeAD was not associated with clinical outcomes (ischemic stroke, mortality, and sICH; all p > 0.05). Conclusions mCeAD does not appear to increase risk of subsequent stroke as compared to sCAD despite baseline risk factors suggestive of vasculopathy. mCeAD patients who did develop a stroke presented with milder strokes and less often had vessel occlusions compared to those with sCeAD. The presence of mCeAD did not impact outcomes.
Effects of Intradural Extension of Extracranial Cervical Artery Dissection on Outcomes: A Secondary Analysis From the STOP ‐ CAD Study
Metanis, Issa , Shu, Liqi , Akpokiere, Favour , Jubran, Hamza , Mandel, Daniel , Nolte, Christian H. , Grory, Brian Mac , Frontera, Jennifer , Khan, Muhib, Rothstein, Aaron , Marto, João Pedro, Zedde, Marialuisa, Poppe, AY, Jubeh, Tamer , AlMajali, Mohammad, Shalabi, Fatma , Henninger, Nils , Rosa, Sara , Khazaal, Ossama , Kaufman, Josefine E., Traenka, Christopher , Bakradze, Ekaterina , Zubair, Adeel , Sousa, João André, Mantovani, Gabriel Paulo , Omran, Setareh Salehi , Elnazeir, Marwa , Sousa, Diana Aguiar de , Yaghi, Shadi, Sousa, João André , Mandel, Daniel M , Frontera, Jennifer , Henninger, Nils , Heldner, Mirjam R , Kaufman, Josefin E , Bakradze, Ekaterina , Zubair, Adeel , Ranasinghe, Tamra , Sousa, Joao Andre , Salehi Omran, Setareh , Elnazeir, Marwa , Yaghi, Shadi , Keser, Zafer , Aguiar de Sousa, Diana , Rosa, Sara , Metanis, Issa , Nolte, Christian H , Mac Grory, Brian , Siegler, James E. , Engelter, Stefan T. , Khan, Muhib , Schwartzmann, Yoel , Zedde, Marialuisa , Keser, Zafer , Antonenko, Kateryna , Heldner, Mirjam R. , Kaufmann, Josefin E. , Ranasinghe, Tamra , Simpkins, Alexis N. , Sargento‐Freitas, João , Yaghi, Shadi , Leker, Ronen R
Annals of Neurology | January 8, 2026 | Volume: 99 | Issue: 5 | Pages: 1189-1197
Objective Cervical artery dissection (CeAD) may be limited to the extracranial extradural space or extend to the intradural space. Intradural extension can potentially increase the risk of stroke and subarachnoid hemorrhage. However, the factors associated with intradural extension and its impact on clinical outcome remain unclear. Methods This was a secondary analysis of the STOP‐CAD observational, multi‐center study. Patients with CeAD and intradural extension (CeADid) were compared with those with pure CeAD extradural dissections (CeADed) using multiple regression analyses. Results Of 4,023 patients with CeAD, 534 (13.3%) had CeADid. In comparison to patients with CeADed, those with CeADid more often had clinical overt stroke or transient ischemic attack (TIA) at presentation, acute infarcts on imaging, a vertebral artery affected, and severe stenosis of the involved vessel ( p < 0.001 for all). In contrast, carotid involvement and complete occlusions were more frequent in patients with CeADed ( p < 0.001 for both). CeADid was associated with a shift in the distribution of scores on the modified Rankin Scale (mRS) toward worse functional outcome (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.62–0.92) but the odds for favorable outcomes (mRS = 0–2) did not differ between the groups after appropriate adjustments on multivariate analysis. CeADid was independently associated with higher mortality at 180 days on multivariate analysis (adjusted OR = 2.84, 95% CI = 1.50–5.38). Interpretation CeADid is associated with more severe clinical presentation, a shift toward less favorable outcomes, and higher mortality rates. These findings suggest that CeADid may represent a high‐risk type of CeAD. ANN NEUROL 2026;99:1189–1197