Evidence map›Paper›PMID 42090170›Full record

SynthesisCirculation2026

Implications of Cranial Arterial Stenosis and Dolichoectasia for Cerebral Small-Vessel Disease Etiopathogenesis: Findings From a Prospective Mild Stroke Cohort.

Fei Han, Una Clancy, Carmen Arteaga-Reyes, Michael J Thrippleton, Maria Del C Valdés Hernández, Daniela Jaime Garcia, Michael S Stringer, Ellen Backhouse, Francesca M Chappell, Yajun Cheng and 12 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Fei HanDepartment of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (F.H., Y.-C.Z.).ORCID 0000-0002-2720-392X
Una ClancyCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-8062-7537
Carmen Arteaga-ReyesCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0003-2424-7123
Michael J ThrippletonCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0001-7858-9917
Maria Del C Valdés HernándezCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0003-2771-6546
Daniela Jaime GarciaCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-9457-9855
Michael S StringerCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-3811-4439
Ellen BackhouseCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0001-5083-9945
Francesca M ChappellCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-7742-1757
Yajun ChengDepartment of Neurology, West China Hospital, Sichuan University, Chengdu (Y.C.).
Dillys Xiaodi LiuDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco (D.X.L.).ORCID 0000-0003-3091-1932
Junfang ZhangDepartment of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China (J.F.).
Angela C C JochemsCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0001-7392-3066
Eleni SakkaCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-7082-1168
Charlotte JardineEdinburgh Imaging Facility, Royal Infirmary of Edinburgh, UK (C.J., G.B., D.M., I.H.).ORCID 0009-0001-3732-4135
Gayle BarclayEdinburgh Imaging Facility, Royal Infirmary of Edinburgh, UK (C.J., G.B., D.M., I.H.).
Donna McIntyreEdinburgh Imaging Facility, Royal Infirmary of Edinburgh, UK (C.J., G.B., D.M., I.H.).
Iona HamiltonEdinburgh Imaging Facility, Royal Infirmary of Edinburgh, UK (C.J., G.B., D.M., I.H.).
Rosalind BrownCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-7688-4864
Yi-Cheng ZhuDepartment of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (F.H., Y.-C.Z.).ORCID 0000-0002-8966-1379
Fergus N DoubalCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-2769-3148
Joanna M WardlawCentre for Clinical Brain Sciences, Department of Neuroimaging Sciences, University of Edinburgh, UK (U.C., C.A.-R., M.J.T., M.D.C.V.H., D.J.G., M.S.S., E.B., F.M.C., A.C.C.J., E.S., R.B., F.N.D., J.M.W.).ORCID 0000-0002-9812-6642

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStenosis and dolichoectasia of cranial arteries likely reflect distinct mechanisms. Their contributions to lacunar stroke and cerebral small-vessel disease (cSVD) remain contentious. We investigated the associations of large-artery stenosis (LAS) and arterial widening with stroke subtype, cSVD markers, incident infarcts, and clinical outcomes.

methodsWe prospectively recruited patients with lacunar or mild nonlacunar stroke, with demographic, stroke-related, cognitive, functional, and magnetic resonance imaging (index and incident infarcts, cSVD markers) assessments at baseline and 1 year. LAS was defined as ≥50% intracranial or cervical artery stenosis; basilar artery dolichoectasia was defined by basilar artery diameter, bifurcation height, and lateral displacement; and intracranial carotid and middle cerebral artery diameters were also measured. Associations were estimated from multivariable logistic, linear, and proportional odds regression models adjusted for age, sex, and vascular risk factors. We further conducted a systematic literature review to synthesize evidence on relationships between large-artery pathology and cSVD.

resultsAmong 229 patients (mean age, 65.9±11.1 years; 131 [57.2%] lacunar stroke), LAS and basilar artery dolichoectasia were present in 20.5% and 15.7%, respectively. After adjustment, LAS (odds ratio, 0.49 [95% CI, 0.23-0.99]) and the presence of any embolic source were associated with lower odds of lacunar versus non-lacunar stroke, and not with cSVD markers or incident infarcts. In contrast, basilar artery dolichoectasia was strongly associated with lacunar stroke (odds ratio, 4.67 [95% CI, 1.87-13.14]), higher cSVD scores (ordinal analysis; odds ratio, 2.57 [95% CI, 1.28-5.25]), incident infarcts (75% subcortical; odds ratio, 2.29 [95% CI, 1.01-5.14]), and greater progression of white matter hyperintensities over 1 year (β, 0.15 [95% CI, 0.01-0.29] per log

conclusionscSVD, including lacunar stroke, was unrelated to LAS but strongly associated with dolichoectasia and wider arteries. These findings support a nonatheromatous, intrinsic microvascular pathology, particularly segmental arteriolar disorganization, as the principal mechanism of lacunar stroke and cSVD. Mechanism-specific diagnostic and therapeutic strategies are warranted.

Indexed as

Cerebral Small Vessel DiseasesStrokeVertebrobasilar InsufficiencyAgedConstriction, PathologicFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesRisk FactorsStroke, Lacunaratherosclerosiscarotid stenosiscerebral small vessel diseasesdilatationstroke, lacunar

Identifiers

PMID42090170
PMCPMC13236046

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.