The Determinants Of Collateral Circulation Status In Atients With Chronic Cerebral Anterior Occlusion

Background:The condition of collateral pathways is an important predictor of stroke prognoses,however,the major determinants of which are still unknown.The purpose of this paper is to identify indicators for collateral circulation status in patients with chronic anterior circulation occlusion.Methods:All patients with either M1-M2 segment middle cerebral artery or internal carotid artery occlusions,diagnosed by digital subtraction angiography at the neurology department of the People’s Liberation Army General Hospital from January 2015 to December 2017,were included in our sample,and their relevant clinical data were collected and analyzed.Collateral circulations were assessed by the American society for interventional and therapeutic neuroradiology/interventional radiology flow-grading system.Results:Baseline characteristics(n=163):our sample consists of 116(71.2%)male and 47(28.8%)female patients with an average age of 57.5(SD,i.e.standard deviation:±11.9).Cerebral collateral flow was poor in 59(36.2%)patients and good in the remaining 104(63.8%),respectively.Our univariate analyses showed that poor collateral circulation was associated with a higher age,elevated homocysteine levels,lower high-density lipoprotein cholesterol content in blood and hyperlipidemia.A multivariate analysis identified age,high-density lipoprotein cholesterol and homocysteine levels as major predictors for collateral circulation status.In the subgroup analysis,the HDL-C contributed to collateral angiogenesis in the internal carotid artery occlusion group.In the middle cerebral artery occlusion group,the age and homocysteine were related to the poor collateral status.Conclusions:Old age,high density lipoprotein cholesterol and high levels of homocysteine are identified as possible risk factors for a poor collateral vessel blood flow in patients with chronic anterior circulation occlusion.