| Vertebral- basilar artery system is an important part of the posterior circulation, mainly supply blood to the back of the brain and posterior cranial fossa. Savitz ′ s research shows that ischemic cerebrovascular disease(ischemic cerebral vascular diseases, ICVD) accounted for about 80% in cerebrovascular disease(cerebral vascular diseases, CVD), and although posterior circulation ischemia(posterior circulation ischemia, PCI) accounts for only 20% of ischemic cerebrovascular disease, however compared with the anterior circulation, it has seriously condition, high morbidity and high mortality, etc.In recent years, with the development of radiological techniques and the noninvasive cerebrovascular examination method was widely used in clinical. It found that there are a lot of patients that their vertebral- basilar artery with different degree of variation. In the clinical work, doctors mostly focus on vascular stenosis and vascular occlusion, however it is failure to recognize the artery curvature and artery circuity.This study through survey of PCI in patients with clinical and imaging data, and investigate the relationship between the basilar artery curvature or circuity and posterior circulation ischemia and its clinical significance. The first part: The correlation between vertebral artery curvature and posterior circulation ischemiaObjective: To investigate the relationship between the basilar artery curvature and posterior circulation ischemia and its clinical significance. Increase the understanding of cerebrovascular disease and as a reference of clinical diagnosis and early prevention.Methods: Collected posterior circulation ischemia patients from November 2013 to October 2014 who hospitalized in neurology, the first hospital, baoding. At the same time collected no intracranial lesions in normal persons as control group. A total of 397 patients were allowed. It detailed records the demographic data(age, gender), vascular risk factors, laboratory examination and maging examination data. It was divided into two groups, basilar artery curvature and basilar artery non-curvature based on a diagnostic criteria of posterior circulation ischemia proposed by Giang and the head MRA examination results. Analyze the relations between basilar artery curvature and posterior circulation ischemia.Results: A total of 536 patients were allowed. There were 139 cases in control group, 77 male and 62 female cases, the average age was 60.40±11.60; and there were 397 cases in PCI group, 220 male and 177 female cases, the average age was 61.70±10.70. Among the posterior circulation ischemia, 127 cases(32.0%) were inspected to exist in basilar artery curvature, and the remaining(68.0%) were not. Among the basilar artery curvature patients, there were 43 cases in type C, 21 cases in anti-C type, 16 cases in S type. There were 149 cases(37.6%) were inspected to exist in basilar artery prolonged. And there were 98 cases(24.7%) exist both basal artery curvature and prolonged. There were no significant differences in the general data(age, gender) and cerebrovascular factors between PCI group and control group,(P﹥0.05). The multiple logistic regression analysis showed that the basilar artery curvature(OR 3.68, 95% CI 3.31 to 12.75; P < 0.001) and basal artery prolonged(OR 3.45,95%CI 3.79~16.55;P<0.001) were independent risk factors of posterior circulation ischemia.Conclusions: The basilar artery curvature were closely related to the occurrence of posterior circulation ischemia. The basilar artery curvature and basal artery prolonged were independent risk factors of posterior circulation ischemia The second part: The correlation between vertebral artery dominance and posterior circulation ischemiaObjective: To investigate the relationship between the vertebral artery dominance and posterior circulation ischemia. Increase the understanding of cerebrovascular disease and as a reference of clinical diagnosis and early prevention.Methods: The patients who were diagnose as ischemic cerebral magnetic resonance(from November 2014 to October 2015) in our hospital were collected. A total of 226 patients were enrolled. It detailed records the general data(age, gender), vascular risk factors, laboratory examination and maging examination data. The decision criteria of VAD is both sides of the difference is 0.3 mm or less 0.3 mm straight line connection side. It was divided into two groups, anterior circulation ischemia stroke(ACIS) group and PCIS group according to infarction region. And to proceeded related statistical analysis.Results: A total of 226 patients were enrolled, including 172(76.1%) patients with ACIS and 54(23.9%) with PCIS. 54 patients were diagnosed as VAD, including 38(70.3%) on the left and 16(29.7%) on the right; 30(55.6%) in PCIS and 24(14.0%) in ACIS. There were significant differences in previous stroke or TIA history(14.8% vs. 7.0%;2=3.130;P=0.077),combined with auricular fibrillation(13.0% vs. 5.8%; 2=3.019; P=0.082) and VAD(55.6% vs. 14.0%;2=39.115;P<0.001) between the PCIS group and ACIS group. Multivariate logistic regression analysis showed that VAD was the independently correlated with PCIS(OR 13.60,95%CI 6.90~27.01;P<0.001).Conclusions: There was significant association between vertebral artery dominance(VAD) and PCIS. VAD may be the independent risk factors for PCIS. |
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