Clinical Analysis Of Collateral Circulation In Patients With Acute Symptomatic Carotid Artery Occlusion

Objective To investigate the assosciation between the clinical manifestation and the intracranial collateral blood flow with ASITN/SIR scale in patients with acute symptomatic unilateral internal carotid artery occlusion(ICAO).Methods seventy-two consecutive patients diagonosed by DSA were included. The types of collateral pathways and volumes of collateral blood flow were studied with DSA according to The American Society of Intervention and Treatment Neuroradiology / Society of Interventional Radiology(ASITN / SIR) scale.Results 1.84.7% ICAO patients were contributed to atherosclerotic etiology. There was no significant difference in primary collateral circulation, secondary collateral circulation, and ASITN / SIR score greater than 2 points between different causes(P>0.05).2. The present rate of primary collateral circulation in transient ischemic attack(TIA) group were higher than that in cerebral infarct(CI) group without significant difference(P>0.05).The ASITN / SIR score greater than 3 points in TIA group was significantly higher than that in CI group(P<0.05). The present rate of secondary collateral circulation in CI group were significantly higher than that in TIA group(P<0.05). 3.There was no significant difference of the present rate of primary and secondary collateral circulation in different types of infarcts.(P>0.05).The present rate of ASITN / SIR score greater than 3 points in IWI and TRI was lower than that in the other two groups without significant difference(P>0.05). 4.The present rate of ASITN / SIR score greater than 3 points in patients with only primary collateral circulation was significantly higher than that in patients with only secondary collateral circulation(P<0.05).Conclusion Atherosclerosis is the commonest etiology of ICAO. Collateral circulation in patients with cerebral infarction is inferior to TIA patients. Primary collateral circulation is an important collateral compensatory way. The opening of secondary collateral circulation which can be partially compensated, but with limited compensatory ability is a sign of hemodynamic failure. IWI and TRI remind us of hypoperfusion. ASITN / SIR score can reflect the status of collateral circulation in patients with ICAO.