Clinical Analysis Of132Patients With Acute Internal Carotid Artery Occlusion

Objective:To analyze the risk factor, imaging findings, clinical manifestations and therapeutic effects in acute cervical internal carotid artery(ICA) occlusive disease.Methods:Selected132cases with acute cervical ICA occlusive disease in Neurology of Jilin Central Hospital from June2004to December2012.All patients were diagnosis by Digital subtract angiography(DSA).The related risk factors,collateral circulation characteristics of different occlusion parts and clinical symptoms were anlyzed in acute ICA occlusive patients. In132patients, interventional manipulation was performed in68cases,the patients were divided into intra-arterial thrombolysis group (N=44) and thrombolysis combined with stent implantation group (N=24),the therapieutic effects was anlyzed between two different methods.Results:In the risk factors in patients with acute ICA occlusion, hypertension was78(59.1%), diabetes mellitus was20(15.2%), hyperlipemia was24(18.2%), atrial fibrillation was34(25.8%),smoking history was64(48.5%),no any risk factors was13(9.8%).In clinical symptoms,TIA was38(28.8%) and CIA was92(69.7%), no any symptoms was2(1.5%),respectively.The cervical segment occlusion was78(59.1%), brain segment occlusion was54(40.9%). The collateral circulation patency,collateral circulation compensation,clinical symptoms and risk factors were no significant differences,but the collateral circulation patency of ophthalmic artery and severely disabled were difference between two groups (P<0.05). In thrombolysis combined with stent implantation group,the revascularization rate, and3months mRs score of <2were significantly higher than that the intra-arterial thrombolysis group,the rate of acute vascular reocclusion within24H was significantly difference between two groups (P<0.05). The rate of postoperative complications was no differences between two groups.Conclusion:Hypertension,diabetes mellitus,hyperlipemia,atrial fibrillation and smoking history were risk factors in patients with acute cervical ICA occlusive disease.Most patients attacked the ACI or TIA.The DSA is very useful to choose treatment methods.Thrombolysis combined with stent implantation is a more effects method in treatment patients with with acute cervical ICA occlusive disease.