Analysis Of Infarct Patterns And Collateral Compensation To Erebral Infarction Patients With The Unilateral Internal Arotid Artery Severe Stenosis Or Occlusion

Objectives: To analyze the infarct patterns and collateral compensation to cerebralinfarction patients with the unilateral internal carotid artery（ICA）severe stenosis orocclusion.Methods: Retrospective studying of one hundred and twelve acute ischemic strokepatients. All patients were divided into ICA disease, middle cerebral artery（MCA）disease,or control group (CG, slightly stenosis group). According to the infarct lesion wereclassified as single and multiple, the former was divided into perforating artery infarct(PAI), pial infarct(PI) and border-zone infarct(BZ). We studied the infarct patternsaccording to the DWI performed and analyzed the information about the primary andsecondary collateral compensation on the basis of DSA. Application of Barthel index andmodified Rankin scale, we evaluated the prognosis three months later.Results: Distribution of lesion patterns in three groups might be different(P=0.001).The DWI multi-infarct pattern was more seen in the two morbid groups; Compared withnegative group, pial infarct with perforating artery infarct appeared more often in the ICAlesion group（P=0.005), concomitant perforator with border-zone infarcts were more seenin the MCA lesion group（P=0.006); The extent of the blood vessel stenosis was connectedto the infarct patterns, the more serious of ICA stenosis, concomitant perforator and pialinfarcts were more common in patients with ICA disease(P=0.003), and the more heavierof MCA stenosis, concomitant perforator with border-zone infarcts were more often inpatients with MCA disease(P=0.043); The incidence of collateral circulation was89.66%(52/58), and the incidence of the circle of Willis mixed with the second collateralcirculation was60.34%(35/58), anterior communicating artery,27.59%(16/58), posteriorcommunicating artery,32.76%(19/58), ophthalmic artery,37.93%(22/58), leptomeningeal artery,39.66%(23/58); The incidence of ophthalmic artery was higher in ICA occlusivedisease (P=0.005); The function recovery was poorer in ICA disease three months later (P=0.002).Conclusions：Pial infarct with perforating artery infarct were more seen in acutecerebral infarction patients with ICA stenosis severe or occlusion, and the maincompensatory approach for those patients was the circle of Willis mixed with the secondcollateral circulation; The incidence rate of ophthalmic artery was more in ICA occlusivegroup than ICA severe stenotic group; Blood vessels stenosis more heavier, less collateralcompensation, the prognosis was worse; Concomitant perforator with border-zone infarctswere more often in MCA severe stenotic or occlusive patients.