Cerebrovascular ischemic events in patients with internal carotid artery occlusion:an analysis of the follow-up results / 中国脑血管病杂志

ABSTRACT

Objective Tofollowupandanalyzetheoccurrenceofcerebrovascularischemiceventsin patientswithinternalcarotidarteryocclusion(ICAO).Methods Atotalof144consecutivepatients with ICAO admitted to the Department of Neurology,the Air Force General Hospital from January 2007 to January 2012 were enrolled retrospectively. All patients were confirmed as unilateral ICAO with DSA and they were divided into either a symptomatic group (n=74)or an asymptomatic group (n=70)according to whether they had the symptoms of ischemic cerebrovascular disease or not. Both patients of the 2 groups were followed up for at least 2 years. Their transient ischemic attack (TIA)and endpoint events were observed,including new symptomatic cerebral infarction,death from any cause,as well as patency of collateral circulation,andthefollow-upresultsbetweenthetwogroupswerecompared.Results Twenty-one patients (28. 4%)of the symptomatic group had new attack of cerebral infarction,10 cases (13. 5%)had TIA,and 4 cases (5. 4%)died;9 patients (12.9%)of the asymptomatic group had new attack of cerebral infarction,4 cases (5 . 7%)had TIA,and no patients died. Risk of recurrent stroke in patients of the symptomatic group was higher than that of the asymptomatic group (P=0. 025). Kaplan-Meier curves showed that the incidence of endpoint event of the symptomatic group was higher than that of the asymptomatic group (χ2 =8. 428,P =0. 004). There was significant difference in the patent ratio of the primary collateral circulation between the symptomatic group and the asymptomatic group (64. 9%[48/74] vs. 91. 4%[64/70];P=0. 000);the patent ratio of the primary collateral circulation in patients with new cerebral infarction was significantly lower than that in patients without new cerebral infarction (60. 0%[18/30]vs.82.5%[94/114];P=0.013).Conclusion ThepatientswithsymptomaticICAOaremore likely to have cerebral infarction,and they are likely to die. After ICAO,the primary collateral circulation patent has a significant effect on the prognosis.