Univariate analysis of collateral circulation and nerve function in patients with severe stenosis or occlusion of internal carotid artery

Abstract

Objective To investigate the relation between compensation of collateral circulation and the severity of clinical neurologic deficit in patients with severe stenosis or occlusion of the internal carotid artery (ICA). Methods National Institutes of Health Stroke Scale (NIHSS) examination was performed in 52 patients with cerebral infarction caused by consecutive stenosis or occlusion of ICA during admission and digital subtraction angiography (DSA) was employed to evaluate the compensation of collateral circulation to analyze the results through statistical methods. Results DSA demonstrated occlusion oflCA in 18 patients, severe stenosis of unilateral ICA in 28, and severe stenosis of bilateral ICA in 6. Anterior communicating artery (ACoA) compensation was presented in 18 patients;posterior communicating artery (PCoA) compensation appeared in 8;both ACoA and PCoA compensations were showed in 12. Only 14 patients have no compensation by Willis circle. Significant differences of average ranks of the NIHSS were found in non Willis circle (35.75) and Willis circle (23.09) (P 0.05). Conclusions Effective collateral circulation can be established spontaneously through multiple ways when occlusion or severe stenosis of ICA appears. The NIHSS scores and the compensation, the location of vessel occlusion are significantly correlative. It is extremely important to investigate the collateral circulation carefully through DSA before treatment intervention. Key words: Stenosis of internal carotid artery; Occlusion of internal carotid artery; Collateral circulation; Cerebral angiography