The Analysis Of Digital Subtraction Angiography In Unilateral Internal Carotid Artery Stenosis Collateral Circulation

Objeetives:Digital subtraction cerebral angiography (DSA) technology will be appliedfor researching the approach and extent of collateral circulation in patients withunilateral internal carotid artery stenosis and Observe the relationship betweenthe collateral circulation in patients with clinical symptoms.Methods:The author adopt a retrospective analysis of56cases registered in JilinUniversity Sino-Japanese Friendship Hospital during the period from January2009to January2012. Those case unions had been examined by cerebralangiography (DSA) and thereby classified according to the degree of stenosisand further divided into three groups: the mild stenosis group, the moderatestenosis group, and severe stenosis group, meanwhile, another group whichcontains20patients without the above symptom will be taken as the controlgroup for benefiting the analysis of comparison of these two group. Then theywill be named the symptomatic group (cerebral infarction, TIA group) and theasymptomatic group according to its clinical performance. Seldinger technique will be used for puncturing femoral artery as to makecerebral angiography, and record the internal carotid artery stenosis parts, theextent of collateral circulation, the variation of Wills ring. Analyze thosepatients with cerebral infarction and imaging change for finding therelationship between the infarction,coronary arteries and collateral circulation.The statistic tool and method adopted in this paper will be SPSS17.0software,chi-square test and variance analysis respectively for collecting and analyzingdata. The result (P<0.05) is statistically significant.Results:1、There are9cases of internal carotid artery with mild stenosis (16.1%),15cases with moderate stenosis (26.8%),32with severe stenosis (57.1%) inthe total56cases.2、26cases are in the situation of anterior communicating artery opened,18cases for posterior communicating artery open,16cases arefore-leptomeningeal anastomosis opened,22cases are rear-leptomeningealanastomotic branch opened, five for ophthalmic artery open,3for perforatingartery open, and there rest3cases for other symptom.3、There is a high opening rate (81.2%) of collateral circulation of theunilateral internal carotid artery re-stenosis group, comparing with controlgroup, differences are significant (P <0.001); the opening rate are relatively lowin mild and moderate stenosis group with the percentage of22.2%and20.0% respectively, there is no significant difference revealed in comparing with thecontrol group (P=0.676, P=0.551).4、 The opening ratio of the primary collateral circulation in thesymptomatic group was significantly less than the asymptomatic group, therebythe significant differences reveal(P=0.042); as to the opening ratio ofsub-prime collateral circulation in the symptomatic group is higher than theasymptomatic group, a significant difference is presented as well(P=0.022).5、 Significant differences revealed in the percentage infore-communicating artery open(P=0.038); result reverse in opening ratio ofthe posterior communicating artery in the symptomatic group andasymptomatic group as there was no significant difference (P=.382).6、it has determined by+DWI scanning2out of the mild stenosis groupare cerebral infarction, taking22.2%,5out of moderate stenosis group, theinfarction rate is33.3%,24out of severe stenosis, occupying75.0%. By thechi-square test, the infarction rate in severe stenosis was significantly higherthan that in light and moderate stenosis group, which presents significantdifferences.Conelusion:1、 The internal carotid artery stenosis can be a cause of diverseintracranial collateral circulation opening, and the opening rate grows with theincrease of the degree of stenosis, the growing of opening rate in i severestenosis group is the most severe one. 2、The primary collateral circulation is a major intracranial collateralcirculation compensatory way, the secondary collateral circulation isfunctioning when primary collateral circulation facing hypoplasia and cannotbe fully supply blood, besides its marks is the emergence of intracranialischemiamore.3、 The degree of openness of the anterior communicating arterydetermine the incidence of cerebral infarction, the higher the degree ofopenness, the rate of infarction is lower in the corresponding parts of thecerebral; the degree of the opening of the posterior communicating artery andthe occurrence of cerebral infarction has no significant correlation.4、 Digital subtraction cerebral angiography (DSA) has an irreplaceableimportance in analyzing and evaluating the circumstance of intracranialvascular collateral circulation.