The Relationship Between The Severe Carotid Artery Stenosis Or Occlusion Patients And Collateral Circulation

Severe carotid artery stenosis or occlusion is common in clinicalpractise,but the neurological effects vary between patients, some studies foundan association between symptoms and collateral flow,but Other studies foundno evidence that the clinical presentation associated with an ICA occlusion wasrelated to collateral pathways。This study aims to explore the relationshipbetween the severe carotid artery stenosis or occlusion patients and collateralcirculation.In Decembe2009to December2011in our clinic or hospital ward120cases of severe carotid artery stenosis or occlusion with the method of digitalsubstraction angiography. Firstly,.120patients were divided into severestenosis group,and occlusive group. Analyze the relationship between thedegree of carotid artery stenosis and collateral circulation;Secondly,:87cerebralinfarction patients with unilateral internal carotid artery stenosis or occlusionwere divided into two groups (collateral flow group and without collateral flowgroup). The result of the two groups in NIHSS scores at admission and14dwere compared. Thirdly, Analyze the relationship between the NIHSS scores atadmission and collateral type.As shown in the results,(1) The proportion of collateral circulation：severestenosis group was less than occlusive group (2)The proportion of mildneurological deficits at admission：without collateral flow group was less thancollateral flow group (3) There are statistical significances in NIHSS score at14d between group with collateral circulation and group without collateralcirculation.(4) The proportion of mild neurological deficits： secondarycollateral circulation group was less than primary collateral circulation group. Base on the results above，we summarized such conclusions as following:(1) The presence of collaterals increased with the severity of stenosis of theunilateral carotid lesion.(2) Patients with collateral circulation have more littleneurologic impairment and better prognosis than patients without collateralcirculation when carotid artery severe stenosis or occlusion.(3) primarycollateral circulation and secondary collateral circulation of ischemic brain playa role compensatory all blood, primary collateral circulation as the main reserveway, when primary collateral circulation reparative ability is insufficient,secondary collateral circulation can be part of the brain ischemia compensatory,and secondary collateral circulation presence generally tips for cerebralperfusion level of serious damage.