Analysis of collateral circulation in patients with acute symptomatic internal carotid artery occlusion
11.3969/j.issn.1672-5921.2015.04.003
- VernacularTitle:急性症状性颈动脉闭塞患者侧支循环的分析
- Author:
Cong ZHANG
;
Yong ZHANG
;
Xiaojun JI
- Publication Type:Journal Article
- Keywords:
Carotid artery diseases;
Brain ischemia;
Collateral circulation;
Angiography,digital subtraction;
Watershed infarction
- From:
Chinese Journal of Cerebrovascular Diseases
2015;(4):180-184,198
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the analysis of collateral circulation in patients with acute symptomatic internal carotid artery occlusion (ICAO)and its clinical significance. Methods Seventy-two consecutive patients with symptomatic ICAO diagnosed by digital subtraction angiography (DSA)were enrolled retrospectively. The American Society of Intervention and Treatment Neuroradiology / Society of Interventional Radiology (ASITN/ SIR)scores were used to evaluate the collateral circulation in the region of ICAO,and the collateral circulation of the patients with different causes,different clinical manifestations, and different types of infarcts were compared. Results Of the 72 patients with ICAO,61(84. 7%)had atherosclerotic occlusion,8(11. 1%)had cervical dissection,and 3 (4. 2%)had cardioembolism;55 patients (76. 4%)had cerebral infarction and 17(23. 6%)had transient ischemic attack. There were no significant differences in the ASITN/ SIR scores among the different causes (P > 0. 05). The ASITN/ SIR scores in patients with cerebral infarction and transient ischemic attack were 2. 64 ± 0. 80 and 3. 29 ± 0. 69 respectively. There was significant difference (P < 0. 05). In patients with cerebral infarction,the ASITN/SIR scores in patients with internal watershed infarction and regional cerebral infarction only were 2. 43 ± 0. 68 and 2. 36 ±0. 51 respectively,they were lower than the patients with only external watershed infarction only and/ or cerebral infarction in cortical territory (3. 42 ±0. 90,P <0. 05). Conclusion Atherosclerotic occlusion is the most common cause of ICAO. ASITN / SIR scores may reflect the conditions of collateral circulation in patients with ICAO. The occurrence of internal watershed infarction and regional infarction indicates the collateral circulation is poor,and need for further therapeutic intervention.