Internal Carotid Artery Stenosis Or Occlusion: Clinical Findings And The Angiographic Evaluation Of Collateral Blood Flow

Objectives: To investigate the clinical features of patients with different degree of internal carotid artery stenosis or occlusion( ICASO);using digital subtract angiography (DSA) to evaluate the change of collateral supply.Methods: 52 cases of angiography confirmed internal carotid artery stenosis or occlusion ( ICASO) were chosen to analyse their clinical features.DSA was used to evaluate the collateral supply.Results: 30 cases had cerebral infarction(1 case also had transient ischemic attack), 12 cases had transient ischemic attack,3 cases were subarachnoid hemorrhage, and 8 cases had no neurological symptoms or signs. Statistic analyse: â‘ the present rate of collateral blood flow in the group of ICA occlusion is 80.8%, significantly higher than 46.2% in the group of ICA stenosis(P=0.010); â‘¡the present rate of posterior communicating artery (PCOA) in the group of ICA occlusion is 53.8%, significantly higher than 23.1% in the group of ICA stenosis (P = 0.022); â‘¢the present rate of cerebral infarction in the group with presence of collateral flow via ACOA is 22.7%, significantly lower than 73.3% in the group without presence of collateral flow via ACOA(P=0.001); â‘£the present rate of cerebral infarction in the group with presence of collateral flow via PCOA is 50%,and in the group without presence of collateral flow via PCOA is 53.1%. No statistically significance was found between the two groups.Conclusion: In patient with internal carotid artery stenosis or occlusion, numerous collateral pathways were recruited to maintaine adequate cerebral blood flow. In our study, the higher degree the artery stenosis is, the more collateral circulation will be recruited. In the presence of poor collateral blood supply from ACOA, cerebral infarcts are more likely to occur.