The Relationship Between Angiographic Features And Clinical Characteristics In Intracranial Atherosclerotic Stenotic-occlusive Lesions

Objective:To identified the relationship between angiographic morphology and infarct mechanisms, early neurological deterioration, collateral circulation in intracranial anterior and posterior circulation atherosclerotic lesions. Materials and Methods:We retrospectively analyzed 108 cases(BA group 38 cases, MCA group 70 cases) which diagnosed isolated intracranial artery severe stenotic-occlusive lesion by DSA from January 2013 to December 2015. We assigned the groups based on DSA imaging of the lesion location, lesion characteristics, lesion degree and collateral circulation, and used the CISS classification and its standards on infarction mechanisms of large artery atherosclerotic stroke subtype to explore the relationship between intracranial vascular lesion location, lesion angiographic morphology and clinical features. Results:Compared the MCA stenosis group with occlusion group, the higher grade collateral circulation(Grade SIR3-4) was significantly lower in stenosis group. Considering the compensatory model, both of them were with ACA compensation primarily, followed by the combination of ACA and PCA compensation, but the constituent ratio between were different. From the view of Infarction mechanisms, parent artery(plaque or thrombus) occluding penetrating artery mechanism was more common in stenosis group,but there was no statistical significance. From the proportion of TIA, the two groups were significantly different. When we subgrouped the MCA stenosis group by morphological features, we found dilatation pattern had the lower grade SIR. Compared with non-END patients, END group was significantly different in the NIHSS score on admission and collateral circulation scale.There were no significant difference between BA stenosis and BA occlusion group in infarction mechanisms. Compared the BA stenosis group with occlusion group, the higher grade collateral circulation was significantly lower in stenosis group. END groups showed no significant difference on angiographic morphology and infarct mechanisms compared with the group without END.We compared the anterior and posterior circulation base on the lesion degree. In the stenotic group, we found that the SIR scale was significantly different between anterior and posterior circulation, and the same result was found in infarction mechanisms, with the exception of percentage of TIA and END. In the occlusive group, the significant difference was only found on infarction mechanisms, with the exception of SIR scale and percentage of TIA and END.Conclusion:MCA occlusion group has higher collateral circulation scale and different compensation mode compared with stenosis group; TIA proportion is significantly higher in stenosis group. BA occlusion group has higher SIR scale than that in the stenosis group. Considering the stenosis subgroup, MCA group has higher SIR scale than BA group.There has different infarction mechanisms between MCA and BA when they have the same lesion degree.