Temporal Trends in the Distribution of Extracranial Carotid and Intracranial Artery Disease Among South Korean Stroke Patients.
12 affiliations
- 1Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea. [email protected].
- 2Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
- 3Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea.
- 4Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea.
- 5Department of Neurology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
- 6Department of Neurology, Seoul Medical Center, Seoul, Korea.
- 7Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
- 8Department of Neurology, Yeungnam University Medical Center, Daegu, Korea.
- 9Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
- 10Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
- 11Division of Intensive Care Medicine, Department of Neurosurgery and Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- 12Department of Neurology, Seoul National University Bundang Hospital, Cerebrovascular Disease Center, Seoul National University College of Medicine, Seongnam, Korea.
Abstract
Background and purpose
To examine 16-year temporal trends in the distribution of symptomatic extracranial carotid artery disease (ECAD) versus intracranial artery disease (IAD) among South Korean patients with anterior-circulation steno-occlusive ischemic stroke, and to explore how evolving vascular risk profiles and their management may have influenced these patterns.Methods
Using the CRCS-K-NIH (Clinical Research Collaboration for Stroke in Korea-National Institute of Health) registry, we retrospectively included first-ever ischemic stroke patients admitted to 9 South Korean hospitals from April 2008 to December 2023. Patients with symptomatic ≥50% stenosis or occlusion in the anterior circulation were selected, while those with high-risk cardioembolic sources or rare stroke etiologies were excluded. Temporal trends in the proportions of symptomatic ECAD and IAD were evaluated across four time periods (2008-2011, 2012-2015, 2016-2019, and 2020-2023), and logistic regression was used to assess associations of periods and risk factors with ECAD and IAD.Results
Among 7,978 eligible patients, the unadjusted proportion with ECAD decreased linearly, whereas the unadjusted proportion with IAD remained stably predominant. Over the same period, age, diabetes and obesity prevalence, and pre-stroke use of antihypertensive, antidiabetic medications, and statins increased, while current smoking declined. Temporal trends in ECAD persisted after adjustment for baseline factors. Use of antihypertensive and antidiabetic medications and current smoking was not associated with the presence of ECAD, while statin use was associated with the presence of ECAD after adjusting for possible confounders.Conclusions
In South Korean patients with anterior-circulation steno-occlusive ischemic stroke, symptomatic ECAD has declined over 16 years, contrasting with the persistently high burden of IAD. Further research is needed to clarify what caused these trends.
Related
- Imaging Correlation of Color Doppler Ultrasound, CT Angiography, and MR Angiography Findings in Extracranial Carotid and Vertebral Artery Disease Among Ischemic Stroke Patients: A Prospective Observational Study.
- Shockwave Lithotripsy for Severe Calcified Extracranial Vertebral and Carotid Disease Treated With Percutaneous Stenting
- Non-ischemic cerebral enhancing (NICE) lesions after extracranial carotid stenting: A case report
- Territory-based ultrasound assessment for extracranial and vertebrobasilar arterial stenosis and carotid plaque vulnerability: a multicentre comparison with digital subtraction angiography and histopathology
- Hemodynamic Induction of Intracranial Aneurysms via Bilateral Common Carotid Artery Ligation in Rabbits: A Systematic Review and Meta-Analysis
BibTeX
@article{kang2026temporal,
title = {{Temporal Trends in the Distribution of Extracranial Carotid and Intracranial Artery Disease Among South Korean Stroke Patients.}},
author = {Kyusik Kang and Nam Oh Kim and Michelle Sojung Youn and Jong-Moo Park and Jae Guk Kim and Soo Joo Lee and Dae-Hyun Kim and Jae-Kwan Cha and Tai Hwan Park and Jeong-Yoon Lee and Kyungbok Lee and Jun Lee and Hong-Kyun Park and Yong-Jin Cho and Keun-Sik Hong and Mi-Sun Oh and Kyung-Ho Yu and Byung-Chul Lee and Dong-Wan Kang and Beom Joon Kim and Jihoon Kang and Hee-Joon Bae},
journal = {Journal of stroke},
year = {2026},
month = sep,
doi = {10.5853/jos.2025.06737},
url = {https://europepmc.org/article/MED/42894452},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Temporal Trends in the Distribution of Extracranial Carotid and Intracranial Artery Disease Among South Korean Stroke Patients.
AU - Kyusik Kang
AU - Nam Oh Kim
AU - Michelle Sojung Youn
AU - Jong-Moo Park
AU - Jae Guk Kim
AU - Soo Joo Lee
AU - Dae-Hyun Kim
AU - Jae-Kwan Cha
AU - Tai Hwan Park
AU - Jeong-Yoon Lee
AU - Kyungbok Lee
AU - Jun Lee
AU - Hong-Kyun Park
AU - Yong-Jin Cho
AU - Keun-Sik Hong
AU - Mi-Sun Oh
AU - Kyung-Ho Yu
AU - Byung-Chul Lee
AU - Dong-Wan Kang
AU - Beom Joon Kim
AU - Jihoon Kang
AU - Hee-Joon Bae
PY - 2026
DA - 2026/09/30
JO - Journal of stroke
DO - 10.5853/jos.2025.06737
UR - https://europepmc.org/article/MED/42894452
AB - Background and purpose To examine 16-year temporal trends in the distribution of symptomatic extracranial carotid artery disease (ECAD) versus intracranial artery disease (IAD) among South Korean patients with anterior-circulation steno-occlusive ischemic stroke, and to explore how evolving vascular risk profiles and their management may have influenced these patterns.Methods Using the CRCS-K-NIH (Clinical Research Collaboration for Stroke in Korea-National Institute of Health) registry, we retrospectively included first-ever ischemic stroke patients admitted to 9 South Korean hospitals from April 2008 to December 2023. Patients with symptomatic ≥50% stenosis or occlusion in the anterior circulation were selected, while those with high-risk cardioembolic sources or rare stroke etiologies were excluded. Temporal trends in the proportions of symptomatic ECAD and IAD were evaluated across four time periods (2008-2011, 2012-2015, 2016-2019, and 2020-2023), and logistic regression was used to assess associations of periods and risk factors with ECAD and IAD.Results Among 7,978 eligible patients, the unadjusted proportion with ECAD decreased linearly, whereas the unadjusted proportion with IAD remained stably predominant. Over the same period, age, diabetes and obesity prevalence, and pre-stroke use of antihypertensive, antidiabetic medications, and statins increased, while current smoking declined. Temporal trends in ECAD persisted after adjustment for baseline factors. Use of antihypertensive and antidiabetic medications and current smoking was not associated with the presence of ECAD, while statin use was associated with the presence of ECAD after adjusting for possible confounders.Conclusions In South Korean patients with anterior-circulation steno-occlusive ischemic stroke, symptomatic ECAD has declined over 16 years, contrasting with the persistently high burden of IAD. Further research is needed to clarify what caused these trends.
SN - 2287-6391
SN - 2287-6405
ER -