Background and Purpose: Detection of vascular abnormalities among ischemic stroke patients provides useful diagnostic and prognostic information guiding acute and preventive treatments. We aimed to study the frequency of potentially relevant vascular abnormalities on CTA among Indian patients with suspected ischemic stroke.
Methods: Images of adult patients (≥18 years) with suspected ischemic stroke within two weeks of symptom onset who underwent arch to vertex CT angiograms between July 2015 and June 2016 were reviewed for relevant vascular abnormalities. 
Results: Among 281 patients (mean age 42.1±15.5 years; 24.2% females) included, 54.4% had intracranial steno-occlusive lesions involving one or more artery and 91.6% of these lesions were in the artery supplying the ischemic territory. Most (62.7%) patients having intracranial steno-occlusive lesion had concurrent (tandem) extracranial stenosis/occlusion. Intracranial LVO was detected among 45% and 35% of patients when CTA was performed within 6 and 6-24 hours respectively vs 30% when 24 hours after symptom onset. Atherosclerosis was evident in the aortic arch in 36.3%, cervical vessels in 38.1% and intracranially in 36.3% patients. Associated luminal stenosis of >50% was found in 49.5% of cervical and 47.1% of intracranial atherosclerosis group. Arterial dissections involving cervical arteries were seen in 21.4% patients, and predominantly affected carotid arteries (61.6% of all cervical cases). 
Conclusion: Nearly a third to half of the ischemic stroke patients have LVO detected on initial CTA. High incidence of tandem lesions and high atherosclerosis burden will pose special challenges during mechanical thrombectomy of LVO lesion and/or carotid stenting in India.

RATE AND RELEVANCE OF VASCULAR ABNORMALITIES IN THE CERVICO-CEPHALIC ARTERIES DETECTED ON CT ANGIOGRAPHY AMONG INDIAN PATIENTS WITH SUSPECTED ISCHEMIC STROKE