| Objectives:To analyze the incidence rate, stenosis degree distribution, and the patterns of collateral circulation of The TIA patients'intra-and extra-cranial artery stenosis and the relationship between artery stenosis and age of TIA patients through digital subtraction angiography. Subjects and Methods:The clinical data from 102 resident patients with transient ischemic attack who had cerebral angiography from China-Japan Union Hospital and the first hospital of Jilin University from 2008 to 2011 were analyzed.According to NASCET,cerebral ateriostenosis was grouped into four grades:â‘ light range, which was obstructed not more than 29%,â‘¡midrange, which was obstructed more than 30% and not more than 69%,â‘¢serious range, which obstructed more than 70%,â‘£obstruction thorouhgly. Compare the distribution of intra-and extra-cranial artery stenosis in different age patients. All the patients were divided into different groups according to the distribution of intra-and extra-cranial artery stenosis of the patients in all groups. They were also divided into carotid artery system TIA(n=75)and vertebrobasilar artery system TIA(n=27)groups according to the clinical manifestation at the onset of the disease.Results:l.The DSA results were postive in 89 cases(87.3%,89/102) and 151 stenoses were found in this study.Among these stenoses,105 lesions(69.5%) occurred in the intracranial arteries and 46 lesions(30.5%) in the extracranial arteries. In the intracranial counterpart,MCA stenoses were most common (33.1%)and the origin of ICA (15.9%)and the origin of VA(11.9%)were most common in the extracranial segments.2.In the extracranial artery stenosis group,we found the origin of ICA stenoses(61.1%) were most common in patients with into carotid artery system TIA and the origin of VA stenoses(60.0%) in patients with vertebrobasilar artery system TIA. In the intracranial artery stenosis group,MCA stenoses(58.6%)and VA stenoses (34.3%) were most frequently found in the patients with into carotid artery system TIA and vertebrobasilar artery system TIA seperately.3.In the patients younger than 50 years, we found 24 patients (85.7%)with intracranial guilty artery and 4 patients(14.3%) with extracarnial guilty artery and intracranial-extracranial guilty artery. In the patients elder than 50 years, we found 21 patients (34.4%)with intracranial guilty artery and 40 patients(55.6%) with extracarnial guilty artery and intracranial-extracranial guilty artery.4.Among the 89 DSA positive cases,there were 47 collateral pathways were identified by angiography:22(46.8%)through the anterior communicating artery,8(17.0%)through the posterior communicating artery,15(31.9%)through the leptomeningeal Pathways,2(4.3%)through the intraeranial-extraeranial pathway. The circle of Willis and leptomeningeal pathway are the most frequent collaterals.5.We divided the 89 DSA positive patients into two groups:11 (29.7%) lesions led to collateral cireulation in the 37 patients with mild and moderate stenoses,and 36 lesions(69.2%)did it in the 52 patients with severe stenoses and occlusions. The occurrence of collateral circulation was more frequent in cases with severe stenoses and occlusions than in cases with mild and moderate stenoses(P<0.05).Conclusions: 1.Large arterial senoses both in intra-and extra-cranial arterial system is the key factor of TIA.2.Intracranial artery stenosis is more often than extracranial artery stenosis. The guilty ateries are most frequently identified as MCA of intracranial artery.3.In the extracranial artery stenosis,the origin of ICA of into carotid artery system TIA patients and the origin of VA of vertebrobasilar artery system TIA patients were easily involved.4.The distribution of intracranial artery stenosis differs according to different ages.Intracranial artery stenosis or occlusion is more frequent in patients younger than 50 years.5.The circle of Willis and leptomeningeal pathway are the most frequent collaterals. More severe stenoses lead to more collateral cirulations.
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