The Relationship Between Vertebral Artery Dominance And Posterior Circulation Ischemic Stroke,the Atherosclerosis Of Vertebral Artery Or Subclavian Artery

Objective:To investigate Relationship between vertebral artery dominance and posterior circulation ischemic stroke, the atherosclerosis of vertebral artery, subclavian artery. And to investigate the clinical significance of vertebral artery dominance.Methods:A retrospective analysis of 283 hospitalized patients diagnosed as non cardiac ischemic stroke with clinical data from January 2014 to November 2014 in Neurology Section of Liaoning Provincial People’s Hospital, including the patients’ sex, age, hypertension, diabetes, smoking history, alcohol history etc. All patients were treated by magnetic resonance angiography(MRA) examination. According to the MRA image, these patients were divided into vertebral artery dominant group of 156 cases and non-vertebral artery dominant group of 127 cases. Also we adopt the color Doppler flow imaging technology(CDFI) to assess the atherosclerosis of vertebral artery and subclavian artery. To compare the vertebral artery dominant group and the non-dominant group with the incidence of posterior circulation infarction and atherosclerosis. Using SPSS17.0 software for statistical analysis, P <0.05 was considered statistically significant.Results:Detection of 283 patients with non cardiac ischemic stroke with vertebral artery dominance ratio higher than the non vertebral artery dominance(55.12% VS 44.88%). Circulation infarction in all patients after 65 cases(65/283), which is the advantage of 52 cases of vertebral artery(52/65,80%), 13 cases of non dominant(13/65,20%).The incidence of vertebral artery dominance group than that of non vertebral artery dominance group with posterior circulation infarction was high, there was significant difference between two groups(P<0.001). The dominant group had 33 cases of vertebral atherosclerosis(33/156,21.15.86%), the non dominant group had 6 cases of vertebral artery atherosclerosis(6/127, 4.72%),detection rate of atherosclerosis of vertebral artery in vertebral artery dominance patients is higher than that in the non dominant group(21.15% VS 4.72%,P<0.01), which had statistically significant difference. The dominant group had 30 cases of subclavian artery atherosclerosis(30/156,19.23%), the non dominant group had 42 cases of subclavian artery of atherosclerosis(42/127, 33.07%),detection rate of patients with subclavian atherosclerosis bewteen the two groups had statistically difference(19.23% VS 33.07%, P<0.05). The dominant group had vertebral atherosclerosis with subclavian artery of atherosclerosis in 14 cases(14/156,8.97%), the non dominant group had vertebral atherosclerosis with subclavian artery atherosclerosis in 1 cases(1/127,0.79%), detection rate of atherosclerosis of vertebral artery and subclavian artery in vertebral artery dominance patients is higher than that in the non dominant group(8.97% VS 0.79%,P<0.01), which had statistically significant difference.283 patients were recruited in this study, the detection rate of vertebral artery atherosclerosis(39/283,13.78%), the detection rate of subclavian artery atherosclerosis(72/283,25.44%), detection rate of subclavian artery of atherosclerosis is higher than the detection rate of vertebral artery of atherosclerosis(25.44% VS 13.78%, P<0.01), which had statistically significant difference. In group of vertebral artery dominance, vertebral artery was higher than that of subclavian artery(21.15% VS 19.23%, P<0.01), the difference was statistically significant; in non vertebral artery dominance group the incidence of subclavian artery was high(33.07% VS 4.72%, P<0.01), the difference was statistically significant. Univariate analysis showed that age of patients of vertebral artery dominance was higher than that of the non dominant group, the ratio of male patients was higher than that of non dominant groups; Bivariate correlation analysis of Spearman showed that, vertebral artery dominance and vertebral atheroscleros is positive correlation(r=0.312, P<0.01).multivariate logistic regression analysis showed that, in addition to age, gender, the relationship bewteen vertebral artery atherosclerosis and vertebral artery dominance are independent(OR= 1.474, 95% CI:1.272- 9.486; P<0.05).Conclusion:1.There are more than half of the vertebral artery dominance in patients with ischemic stroke; the ratio of posterior circulation ischemic stroke in patients with vertebral artery dominance is higher.2..Detection rate of subclavian artery of atherosclerosis is higher than the detection rate of vertebral artery of atherosclerosis.But the incidence of vertebral atherosclerosis in vertebral artery dominance including posterior circulation is higher than subclavian artery.3.The atherosclerosis of vertebral artery is associated with vertebral artery dominance independently. It has positive correlation.Vertebral atherosclerosis may be one of the promotion of the occurrence or aggravation of the acquired factors of vertebral artery dominance of this congenitalvascular phenomenon.