The correlation of collateral grading and clinical outcome in carotid severe stenosis

Abstract

Objective To research collateral pathways and collateral grading through digital subtract angiography(DSA) and their relation to clinical prognosis.Methods Collateral pathways and collateral grading of 49 cases suffered from severe internal carotid artery (ICA) stenosis (70% -99% ) were assessed through DSA.Incidence of stroke,TIA or cerebral hemorrhage were observed in the following 12 months.Results ①In all the subjects,no collateral pathway exist in 9 cases(18.9%),and primary and secondary collateral pathways occurred in 39(79.6% ) and 25(51.0%)cases.Pathway is not related to clinical prognosis.②There were 9 ,15 and 25 cases in 0 grade,1 -2 grade and 3 -4 grade collateral circulation and the complication ratio is 44.4%,50.66% and 24.00% respectively.Incidence of ischemic cerebrovascular disease is significantly higher in 3 - 4 grade patinets than those in 0 and 1 - 2 grade pation(x2 =4.856,3.242;all P ＜ 0.05 ).Conclusions Collateral levels but not pathway were correlated with clinical prognosis in patients with severe stenosis of internal carotid artery. Key words: Severe stenosis of internal carotid artery; Digiul subtract angiography; Collateral circulatior; Clinical outcome