Relation Between the Distribution of Cerebral Atherosclerosis and Stroke Risk Factors in Patients with Extracranial Carotid Disease

ABSTRACT

BACKGROUND: In Korean patients, atherosclerotic lesions are more often found in the intracranial rather than in the extracra-nial cerebral arteries compared to Caucasian patients. However, extracranial carotid artery lesions are increasingly recognized in recent years. (recognized by who? Do you mean increasingly found in Korean patients ?) Although some studies have shown Asians to have more intracranial diseases, patients with intracranial stenosis often have extracranial disease. The aim of this investigation was to determine the frequency of combined intracranial atherosclerotic lesions in patients with extracranial carotid disease and to analyze the differences in stroke risk factors between patients with pure extracranial carotid artery disease and those who have combined extra- and intracranial artery disease. METHODS: We reviewed 100 consecutive patients with extracranial carotid artery stenosis (defined as > 30% narrowing of diameter) or occlusion proven by a conventional angiogra-phy. We investigated the distribution of atherosclerotic lesions on the angiography and compared risk factors for atherosclerosis between the pure extracranial carotid occlusive group and the combined extra- and intracranial artery occlusive group. RESULTS: Among 100 patients with extracranial carotid occlusive lesions, combined intracranial stenosis (>30% narrowing of diameter) or occlusion was seen in 67 patients. Multivariate analysis showed that diabetes mellitus was the only factor that was associated with the combined extra- and intracranial artery occlusive groups (p < 0.05). CONCLUSIONS: The combined extra- and intracranial atherosclerotic lesions was were frequently seen in Korean patients. Diabetes mellitus may play an important role in the devel-opment of intracranial atherosclerosis in patients who have combined extra- and intracranial occlusive disease.