Carotid Plaques Or Stenosis Relationship With Clinical Classification Of Ischemic Cerebrovascular Disease

Objective Application of MRA and CTA screening of patients with Ischemic stroke, explicit the carotid artery plaque or stenosis site, location and degree of stenosis, and classify the Ischemic stroke by clinical classification. To investigate the relationship between the carotid artery stenosis or carotid plaque and subtype of Ischemic cerebral vascular disease.Method 104 patients with acute cerebral thrombosis with explicit carotid artery plaque and artery stenosis by head and neck MRA or CTA were admitted from Sep.2012 to Sep. 2013 to the neurology department of our hospital in this study. All stocke patients were divided into transient ischemic attack(TIA) and acute cerebral infarction(ACI).The TIA patient’s clinical symptoms were confirmed to relating to carotid artery stenosis, the ACI patients adopt CISS typing with five type, LAA, CE, PAD, SOE, SUE. We don’t definited diagnose the SUE patients, so we discuss the first 4 types. Position of carotid artery stenosis,severity of artery stenosis and vascular location were observed and studied. We analyse the related data by ssp 17.0 and pems 3.1.Results(1)The general situation: 104 cases of acute ischemic cerebrovascular disease combination of carotid plaques and(or) stenosis in patients with TIA in 40 cases, 64 cases of cerebral infarction; 35 cases of 69 men, women, men with an average age of 64.46±9.23 years of age, women with an average age of 69.03±10.53 years old. The more women than men are patients’ average age is big, P<0.05,the difference was statistically significant. Men in each age group and the proportion of high, P<0.05,the difference was statistically significant. All cases 78 cases of hypertension, diabetes mellitus(19 cases), 8 cases of atrial fibrillation(af), 40 cases of hyperlipemia.(2)Risk factors: 104 cases of acute ischemic cerebrovascular disease combination of carotid plaques and(or) stenosis in patients with risk factors analysis,the highest proportion of hypertension, the proportion is 75%, then followed by smoking, high cholesterol, homocysteine hematic disease, alcohol abuse, diabetes, atrial fibrillation, proportion were 59.6%, 38.5%, 36.5%, 23.1%, 7.7%. Risk factors among clinical classification analysis, of which the LAA and SOE, PAD and SOE group of hypertension is statistically significant( P<0.05); LAA with SOE, PAD and the SOE group, hyperlipidemia is statistically significant that SOE of hypertension and hyperlipidemia less; No statistical differences between groups in diabetes and atrial fibrillation(af).(3)Clinical classification:104 cases of acute ischemic cerebrovascular disease combination of carotid plaques and(or) stenosis in patients, 64 cases of cerebral infarction, TIA 40 cases, higher proportion of cerebral infarction, specific classification TIA(38.5%), LAA type to a common type of cerebral infarction, 34 cases, accounted for 32.7%, followed by PAD, 17 cases, accounting for 16.3%.(4)Severity of carotid artery stenosis:104 cases of ischemic cerebral apoplexy according to groups of carotid stenosis degree with mild stenosis most, followed by moderate stenosis, severe stenosis, severe occlusion lowest proportion, the proportion were 54.8%, 20.2%, 15.4%, 9.6%.Cerebral infarction CISS parting in LAA merge most common carotid stenosis, followed by the PAD group. Narrow the blood vessels distribution in ICA most, followed by CCA. Common carotid artery and internal carotid artery plaque and stenosis after the location of the pipe cavity wall is in the majority; Longitudinal cutting position to the internal carotid artery in the majority, followed by end of the internal carotid artery transition department is in the majority of the internal carotid and middle cerebral artery. Common carotid artery and internal carotid artery plaque and stenosis after the location of wall in the majority; Longitudinal cutting position to the internal carotid artery in the majority, followed by the end of the internal carotid artery.(5)Anatomy of the cerebral infarction position classification:At present foreign internal carotid artery stenosis or occlusion of infarction form(infarction model) is divided into cortex, subcortical infarction, marginal zone infarction and multiple infarction rim. In this study, 64 patients with carotid stenosis or occlusion with cerebral infarction, cortex infarction, 34 cases(53.1%), 20 cases of subcorticalinfarction(31.3%), and marginal zone infarction, 10 cases(15.6%), multiple infarction in 37 cases, the proportion of 57.8%.(6)The progressive of cerebral infarction and the nonprogressive cerebral infarction:64 patients with cerebral infarction were divided into 20 cases of progressive cerebral infarction group and nonprogress 44 cases of cerebral infarction group, progressive cerebral infarction(31.3%).Found moderate- severe carotid stenosis in the highest correlation with progressive cerebral infarction with multiariable Logistic regression analysis.Conclusion(1)All the cases, the proportion of cerebral infarction is higher than TIA, men more than women, the average age of women than men, in each age group and the proportion of men with high.(2) All the cases, combination of hypertension is the highest percentage, followed by smoking, high cholesterol, high blood type with cysteine, alcohol abuse, diabetes and atrial fibrillation. Between the clinical classification of risk factors analysis found that SOE complicating hypertension and hyperlipidemia was less.(3) The proportion of cerebral infarction is higher, followed by TIA;LAA for common type cerebral infarction, followed by the PAD type in CISS clinical classification.(4) Most mild stenosis in carotid artery stenosis, LAA merge most common carotid stenosis, followed by the PAD group in CISS clinical classification. The internal carotid artery stenosis is most. In vascular longitudinal cutting position, the internal carotid artery stenosis is in the majority.(5) According to the anatomical position of the cerebral infarction, most common cortical infarction, followed by subcortical infarction, marginal zone infarction.(6) Found moderate- severe carotid stenosis in the highest correlation with progressive cerebral infarction.