The Related Factors And Effect On Clinical Outcome Of Collateral Circulation With Symptomatic Intracranialarterial Stenosis Or Occlusion

Objective:To investigate the contributing factor of collateral circulation and effect of collateral circulation perfusion on infarct size and clinical symptoms in patients with severe intracranial artery stenosis or occlusion.It is major to collect evidences for prognosis and treament.Method:Analysis of 142 patients with severe intracranial arterial stenosis or occlusion in our hospital from December 2014 to March 2017.Age,sex,hypertension,diabetes,homocysteine,total cholesterol,low density lipoprotein,high density lipoprotein,smoking and drinking history will be registered on all patients.The NIHSS and ADL score were recorded at admission.All patients underwent magnetic resonance diffusion imaging(MRI+ DWI),and the infarct size was calculated.Aortic arch and digital subtraction angiography(DSA)were underwent on all patients to evaluate the perfusion of collateral vessels.Patients were divided into a good collateral circulation perfusion(3-4 grades)and the poor collateral circulation perfusion(0-2 grades)according to the collateral circulation of the American Radiological Intervention Society.T-test,chi-square test and logistics regression were used to analyze the data of two groups.Result :68 patients were in good collateral circulation perfusion and 74 patients were in poor collateral circulation perfusion.Age,sex,diabetes,homocysteine,total cholesterol,low density lipoprotein,smoking and drinking history of the two group were no significant difference in statistics(p > 0.05).Hypertension,high density lipoprotein were significant difference in statistics(p < 0.05).The volume of size of cerebral infarction was significantly decreased(p < 0.05),when there were good collateral circulation perfusion.The NIHSS scores were fewer and ADL scores were higher in the good group were higher(p < 0.05).Conclusion : 1.Higher HDL and appropriate HBP are related to good collateral circulation perfusion.2.The clinic study was concluded that good collateral circulation perfusion is the protective factor of acute cerebral ischemia and can reduce the volume of cerebral infarction significantly.It can reduce the clinical symptoms of cerebral ischemia and improve the daily living ability of patients.