| Objective:To investigate the recurrence rate of cerebral ischemic stroke and mortality in patients with internal carotid artery occlusion(ICAO).Methods:144 patients with ICAO were admitted to the Department of Neurology, Airforce General Hospital from January 2007 to January 2012 were enrolled. According to the clinical manifestation, All patients confirmed with DSA were divided into 2 groups: symptomatic group(74 cases) and asymptomatic group(70 cases),they were also confirmed with the outcomes divided into new cerebral infarction groups(30cases) and none new cerebral infarction group(114 cases). They were followed for at least 2 years and their information were obtained on TIA,the occurrence of endpoint events(new cerebral infarction and death from any causes) and collateral circulation. New cerebral infarction and death from any causes were analyzed and compared between the symptomatic group and asymptomatic group. Kaplan-Meier method was employed to analyze the endpoint events. Collateral circulation was compared between the symptomatic group and asymptomatic group. Collateral circulation was also compared the differences between the new cerebral infarction groups and none new cerebral infarction group.Results:Among 144 patients,30 cases underwent new cerebral infarction,14 cases presented with TIA, and 4 patients died during the follow-up period. There were 22 patients suffering from cerebral watershed infarction and 8 patients suffering from none cerebral watershed infarction. In the group of patients with symptomatic ICAO, 21(28.4%) underwent new cerebral infarction,10(13.5%) presented with TIA, and 4(5.4%) patients died during the follow-up period. There were 8 patients suffering from new cerebral infarction and TIA several times. In the group of patients with asymptomatic ICAO,9(12.9%) underwent new cerebral infarction,4(5.7%) presentedwith TIA, and no patients died during the follow-up period. There were 2 patients suffering from new cerebral infarction and TIA several times. Risk of recurrent stoke in patients of the symptomatic group was higher than that of the asymptomatic group(P=0.025).Kaplan-Meier analysis showed that the incidence of endpoint event of symptomatic group was higher than that of the asymptomatic group(χ2=8.428,P=0.004). Among all the patients,the number of occlusion taken place in extracranial ICA is 124(84.1%),intracranial ICA 20(15.9%).In all the 242 opened collateral circulation cases, there were 86 ACOA,58 PCOA,30 ophthalmic artery, 30 former leptomeningeal anastomosis,20 post leptomeningeal anastomosis, 18 new artery. There were In the comparisons between symptomatic group and asymptomatic group, the proportion of opened primary collateral circulation was significant difference [64.9%(48/74)vs94.1%((64/70), P=0.000], the proportion of subprime collateral circulation was not significant difference(54.1% vs40%, P>0.05). Patients with opened primary collateral circulation had less new cerebral infarction compared with those without opened primary collateral circulation [60%(18/30)vs82.5%((94/114), P=0.013], the proportion of subprime collateral circulation was not significant difference(53.3% vs45.6%, P>0.05).Conclusion : Compared with patients with asymptomatic ICAO, patients with symptomatic ICAO had a higher risk of new cerebral infarction and death. Opened primary collateral circulation can effect on prognosis of patients with ICAO.Objective:To investigate the recurrence rate of cerebral ischemic stroke and mortality in patients with vertebral artery origin occlusion(VAOO).Methods:According to the clinical manifestation,156 cases of vertebral artery origin occlusion confirmed by DSA were divided into 2 groups: symptomatic group(n=98) and asymptomatic group(n=58). They were followed for at least 2 years and their information were obtained on new cerebral infarction and death from any cause. New cerebral infarction and any death were the end point event. These information were analyzed and compared. Results The annual new cerebral infarction rate was 5.1%,and the annual mortality rate was 0.4% in the patients with VAOO at the follow-up. The association between symptomatic group and recurrent cerebral infarction(versus asymptomatic group) was not statistically significant(18.4% vs 17.2%,P>0.05). Kaplan-Meier analysis showed that the incidence of endpoint event of symptomatic group was not higher than that of the asymptomatic group(P=0.690).In the comparisons between symptomatic group and asymptomatic group,the proportion of opened collateral circulation was not significant difference(24.9% vs 25.9%,P=0.566). Opened collateral circulation was not associated with new cerebral infarction( 35.7% vs 22.7%, P=0.148).Conclusion:Few Patients with unilateral vertebral artery origin occlusion had a poor prognosis. |
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