The Study Between Collateral Circulation And Clinical Prognosis In Patients With Unilateral Internal Carotid Artery Severe Stenosis Or Occlusion

OBJECTIVE:To explore the relationship between collateral circulation and clinical prognosis in ischemic stroke patients with unilateral severe stenosis or occlusion of internal carotid artery.METHODS:Unilateral severe internal carotid artery stenosis or occlusion in consecutive acute ischemic stroke patients admitted to our hospital from October 2012 to October 2014 were rated prospectively.Patients were divided into two groups according to the presence of collateral circulation in CT angiography (CTA).we ues National Institutes of Health Stroke Scale(NIHSS) to evaluate clinical prognosis at admission,2 weeks after admission,3 months after admission.Multivariate model were generated to determine the contribution of collateral circulation variables to ischemic stroke prognosis.RESULTS:Of 40 patients,12 cases (57.14%) have collateral circulation in severe stenosis group.17 cases (89.47%) in occlusion group.The ratio of collateral circulation opening in occlusion group is significantly higher than that in severe stenosis group, P = 0.02 (P< 0.05).of 29 cases with collateral circulation,19 cases (65.51%) with primary compensatory and 10 cases (34.49%) with secondary compensatory. Primary compensatory ratio is significantly higher than secondary compensatory (P<0.05). Also we founded that the primary compensatory proportion (76.92%) was significantly higher than secondary compensatory proportion (23.08%) in severe stenosis group, P= 0.001 (P<0.01). But there was no statistically significant difference in the occlusion group, P= 0.615 (P>0.05).6 patients in 8 patients with secondary compensatory in occlusion group, had ophthalmic artery compensatory.the ratio is 75%. the NIHSS scores(admitted to hospital and 2 weeks follow-up) of patients with Collateral circulation was significantly lower than patients without collateral circulation (P< 0.05).CONCLUSION:There is certain relevance between the collateral circulation establishment and narrowed arteries, primary collateral compensation maybe the main way of compensatory, but in patients with internal carotid artery occlusion the compensatory way may be changed, because of the change of the blood dynamics, ophthalmic artery may have special compensation and prompt "With the establishment of the collateral circulation, the NIHSS score of patients with collateral circulation was significantly lower than those patients without collateral circulation, which suggesting the patients with collateral circulation will have a good prognosis.