Vascular ultrasound assessment of internal carotid artery dissection and vertebral artery dissection and the difference analysis of lumen recanalization
10.3969/j.issn.1672-5921.2019.04.002
- Author:
Zhaoqiang LI
1
Author Information
1. Department of Vascular Ultrasonography, Capital Medical University, Xuanwu Hospital
- Publication Type:Journal Article
- Keywords:
Color doppler flow imaging;
Follow-up;
Internal carotid artery dissection;
Recanalization;
Vertebral artery dissection
- From:
Chinese Journal of Cerebrovascular Diseases
2019;16(4):175-180
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To diagnose and test cervical artery dissection (CAD) during the follow-up by color Doppler flow imaging (CDFI) and to analyze and compare the differences of internal carotid artery dissection ( ICAD) and stenosis degree of vertebral artery dissection ( VAD) , and lumen recanalization. Methods From January 2016 to December 2018 , a total of 136 consecutive patients (160 dissecting vessels) with CAD of intramural hematoma type diagnosed by CDFI and confirmed by high-resolution MRI and/or CT angiography in Xuanwu Hospital .Capital Medical University were enrolled retrospectively. They were divided into ICAD group (n =66, with 75 ICADs) and VAD group (n =70,with 85 VADs).The gender, age,risk factors,cerebral ischemic symptoms, and CDFI manifestations were compared in the patients between the two groups. They were followed up at 3,6, and 12 months after onset. The patients with CAD were reexamined, and the difference of recanalization rate between the two groups was compared. Results There was a statistically significant difference in the mean age and proportion of hypertension between the ICAD group and the VAD group (both P < 0. 05 ) There was no significant difference in the side of lesion between two groups of patients with vascular lesions ( P > 0. 05); there was significant difference in the degree of vascular stenosis (P <0. 01). The degree of stenosis in the ICAD group was ≥70% or the number of occluded vessels was significantly higher than that in the VAD group (88. 0% [66/ 75] and 48. 2% [41/85],respectively). Of the 136 patients,at the end of follow-up,a total of 105 patients with 126 lesion vessels were followed up,including 58 ICADs and 68 VADs. At the follow-up of 3 months and 6 months after onset,the complete recanalization rate of the lesion vessels in the VAD group was significantly higher than that in the ICAD group (46.6% [27/58] vs. 21.7% [ 10/46] ,and 58.1% [37/63] ts. 37.3% [ 19/ 51 ]respectively) ,the difference was statistically significant values were 6. 891 and 5. 201 respectively, P values were 0. 009 and 0. 023 respectively);at the follow-up of 12 months after onset, there were no significant difference in the complete recanalization rate of the lesion vessels (60. 3% [41/68] vs. 53.4% [31/58]) and the degree of residual stenosis of lumen (x2values were 0.599 and 0.297 respectively; all P >0. 05) between the VAG group and the ICAD group. Conclusions ICAD was different from VAD in the degree of lumen stenosis and the rate of lumen recanalization at different follow-up time. CDFI had good test and follow-up re-examination values for CAD.
