Observation And Analysis Of The Relationship Between Intracranial Anterior Circulation Vascular Score And Acute Cerebral Infarction In Patients With Internal Carotid Artery Stenosis

Objective: To analyze the relationship between intracranial anterior circulation vascular stenosis and acute cerebral infarction in patients with atherosclerotic internal carotid artery stenosis(ICA).Methods: Retrospectively collected patients with unilateral ICA stenosis ≥50% admitted in the Department of Neurology,People’s Hospital of China Medical University from October 2017 to October 2018,and recorded general information and risk factors of all patients,including age,gender,and hypertension Disease,diabetes,coronary heart disease,smoking history,systolic blood pressure at admission,body mass index,related blood test results,ICA stenosis,intracranial anterior circulation vascular stenosis score,complete circle of Willis,posterior cerebral artery bias score,white matter hyperintensity(WMHs)and lacunar infarction scores,NIHSS scores were performed on patients with symptomatic ICA stenosis,and NIHSS scores ≤ 3 were classified as mild stroke.The above data were compared between patients with symptomatic and asymptomatic ICA stenosis,patients with a NIHSS score of ≤3 and a NIHSS score of> 3.Results: 1.A total of 147 patients with unilateral ICA stenosis ≥50% were included,including 63 patients with symptomatic ICA stenosis and 84 patients with asymptomatic ICA stenosis.Comparing the general information and risk factors of patients with ICA stenosis,it was found that compared with patients with asymptomatic ICA stenosis,the proportion of males with symptomatic ICA stenosis was higher [42(66.67%)vs 42(50.00%),P = 0.043],high density lipoprotein cholesterol was lower [1.03(0.81,1.22)vs 1.03(0.81,1.22),P = 0.024].Comparing imaging data of patients with ICA stenosis,it was found that compared with patients with asymptomatic ICA stenosis,the anterior circulation vascular score was lower in patients with symptomatic ICA stenosis [3.00(3.00,4.00)vs 4.00(3.00,4.00),P = 0.003],The degree of ICA stenosis was higher [2.00(1.00,3.00)vs 1.00(1.00,2.00),P = 0.000].Logistic regression analysis showed that compared with patients with asymptomatic ICA stenosis,patients with symptomatic ICA stenosis had lower anterior circulation vascular stenosis scores(OR = 0.966,95% CI: 0.411～0.979,P = 0.040),and lower high density lipoprotein cholesterol(OR = 0.154,95% CI: 0.042～0.572,P = 0.005),and the degree of ICA stenosis was higher(OR = 2.217,95% CI: 1.162～4.229,P = 0.016).2.Including 57 patients with symptomatic ICA stenosis,29 patients with NIHSS score ≤ 3 points,and 28 patients with NIHSS score >3 points.Comparing the general information and risk factors of patients with symptomatic ICA stenosis,it was found that all parameters were not statistically significant.Comparing imaging data of patients with symptomatic ICA stenosis,it was found that compared with patients with a NIHSS score> 3,WMHs in the ipsilateral subcortex were lower in patients with a NIHSS score ≤ 3 [0.00(0.00,1.00)vs 1.00(0.00,2.75),P = 0.013],the percentage of complete circle of Willis is higher [23(79.31%)vs 11(39.29%),P = 0.002].The results of logistic regression analysis showed that compared with patients with a NIHSS score of> 3 points,patients with a NIHSS score of ≤3 had a higher percentage of complete circle of Willis(OR = 0.229,95% CI: 0.056～0.939,P = 0.041).Conclusion: Patients with moderate to severe ICA stenosis associated with intracranial anterior circulation vascular stenosis are associated with acute cerebral infarction.There was no significant correlation between intracranial anterior circulation vascular stenosis and neurological deficit in patients with symptomatic ICA.