In-Hospital Recovery in Acute Ischemic Stroke with Extracranial and Intracranial Arterial Stenosis

Background: Stroke is a leading cause of mortality and disability globally, with extracranial atherosclerotic stenosis (ECAS) and intracranial atherosclerotic stenosis (ICAS) being critical determinants of stroke outcomes. This study examines how ECAS and ICAS affect recovery in acute ischemic stroke patients. Methods: This cross-sectional observational study included 390 patients with acute ischemic stroke admitted to Tirunelveli Medical College Hospital from August 2022 to November 2023. Patients were categorized into four groups based on stenosis type: non-stenosis, ICAS-only, ECAS-only, and combined ICAS+ECAS. Baseline characteristics, risk factors, and functional outcomes (measured by the modified Rankin Scale, mRS) were analyzed. Hazard ratios and multiple linear regression analyses were used to identify predictors of recovery. Results: Among the 390 patients, 73% were male, with the mean age highest in the combined ICAS+ECAS group (63.0 years). Smoking was significantly associated with the ICAS group, while coronary artery disease (CAD) was more common in patients with both ICAS and ECAS. Regression analysis identified smoking, dyslipidemia, CAD, ICAS, and combined ICAS+ECAS as significant predictors of poorer outcomes, while age, gender, hypertension, and diabetes were not predictive. Conclusion: Patients with ICAS and concurrent ICAS+ECAS exhibited poorer recovery outcomes. Targeted interventions focusing on lifestyle modification and early risk factor management are recommended to improve recovery outcomes in acute ischemic stroke patients.