Comparison of Carotid and Cerebrovascular Stenosis between Diabetic and Nondiabetic Patients Using Digital Subtraction Angiography

Abstract

The aim of our study was to evaluate the differences of prevalence and manifestation of extracranial and intracranial artery stenosis between patients with and without type 2 diabetes using digital subtraction angiography. A retrospective study was conducted by analyzing clinical and lifestyle data collected from 1137 patients enrolled in the Nanjing Stroke Registry Program between June 2004 and March 2011. Vascular risk factors were analyzed, and carotid and cerebrovascular artery stenoses were measured in 383 patients with type 2 diabetes mellitus and 754 nondiabetic patients by digital subtraction angiography. In all, 1069 stenoses were found among 383 diabetic patients and 1990 among 754 nondiabetic patients. No statistical differences were observed for the distribution of stenosis in intracranial-extracranial vessels between diabetic and nondiabetic patients (P=.210). There was no difference in the distribution of stenosis in the anterior and posterior circulation vessels between these 2 groups (P=.628). Among diabetic patients with stenosis, a single stenosis was found in 116 (30.29%) and multiple stenoses were found in 267 (69.71%). In their nondiabetic counterparts, a single stenosis was found in 249 (33.02%) and multiple stenoses were found in 505 (66.98%). Compared with nondiabetic patients, the diabetic patients have a tendency of a higher incidence of multiple stenosis. Nonobstructive stenosis occurs more often in diabetic than in nondiabetic patients (P=.002). This retrospective study suggests that diabetes be associated with higher incidence of nonobstructive stenosis and that there be no significant difference observed in the extent and distribution of the extra- and intracranial artery stenoses between diabetic and nondiabetic patients.