摘要
Abstract
Objective To evaluate collateral circulation features for patients with severe internal carotid artery (ICA) stenosis or occlusion by Digital Subtraction Angiography (DSA), and study the relationship between collateral circulation feature and clinical symptom. Methods It was a retrospective study. A total of 137 patients with ICA severe stenosis (≥70%) or occlusion confirmed by DSA were consecutively enrolled during June 2014 to September 2015 in Dept. of Neurology Intervention, Beijing Tiantan Hospital, Capital Medical University. Patients were divided into asymptomatic group (n=39) and symptomatic group (n=98) according to clinical symptoms, neurological signs and imaging appearance. The DSA results of all patients were collected and collateral circulation compensation status were recorded. Patients' collateral circulation status were classified by following situation: 1. Numbers of collaterals: Patients were classified to with or without collateral circulation by collateral numbers and less than 2 or 2 and more. 2. Collateral circulation status: anteriorcommunicating anastomoses (ACoA), posterior communicating arteries (PCoA), ophthalmic artery (OA), and leptomeningeal anastomoses (LMA). 3. Collateral composition: collaterals were classified according to Willis status and whether have secondary collaterals. The relationship between collateral circulation feature and clinical symptoms was analyzed. Results Among 137 patients, the mean age of patients was (59.7±10.5) years, 97 patients were male, and 94 patients (68.6%) had collaterals. The rate of complete Willis, ACoA, PCoA, OA, and LMA were 14.6%, 58.5%, 46.8%, 43.6%, and 48.9%, respectively. In asymptomatic group (n=39), 33 patients (84.6%) had collateral circulation. In symptomatic group (n=98), 61 patients (62.2%) had collateral circulation. The rate of circulation was significantly higher in asymptomatic group [84.6% vs 62.2%,P=0.011,odds ratio(OR)3.336].Patients in asymptomatic group had more patients with 2 or more collaterals than patients in symptomatic group(64.1% vs 38.3%,P=0.007,OR 2.820). Asymptomatic group had more complete functional Willis(36.4% vs 13.1%,P=0.009,OR 3.786). Conclusion For patients with severe internal carotid artery (ICA) stenosis or occlusion, collateral circulation feature has close relationship with clinical symptom. Asymptomatic patients have more collateral circulation compensatory and more complete circle of Willis. The circle of Willis plays an important role in the compensation of collateral circulation.关键词
颈内动脉重度狭窄/闭塞/侧支循环/Willis环/数字减影血管造影Key words
Severe internal carotid artery stenosis or occlusion/Collateral circulation/Willis circle/Digital subtraction angiography
