Dalainas I, Avgerinos E D, Daskalopoulos M E, Papapetrou A, Papasideris C P, Katsikas V, Xiromeritis K, Moulakakis K, Gianakopoulos T, Liapis C D
Department of Vascular Surgery, Attikon University, Hospital, University of Athens, Athens, Greece.
Int Angiol. 2012 Feb;31(1):16-21.
The ipsilateral external carotid artery (ECA) can potentially provide an important collateral pathway for cerebral blood flow in the presence of occlusion or severe stenosis of the internal carotid artery (ICA), recovering up to 15% of the middle cerebral arterial flow. The aim of the study is to elucidate the role of ECA in cerebral flow of patients with total ICA occlusion.
Retrospective study of prospectively collected data of 139 patients with total ICA occlusions. The patients were divided to symptomatic and asymptomatic and were categorized in four subgroups according to the stenosis rates: A) ipsilateral ECA<70% and contralateral internal carotid artery stenosis <70%; B) ipsilateral ECA stenosis <70% and contralateral internal carotid artery stenosis ≥70%; C) ipsilateral ECA stenosis ≥70% and contralateral ICA stenosis <70%; D) ipsilateral ECA stenosis ≥70% and contralateral ICA stenosis ≥75%.
Fifty eight (41.7%) patients were asymptomatic. The highest rate (48.2%) of asymptomatic patients was in Group A. Among patients with strokes, the highest rate belonged in groups C and D (44.4% and 50% respectively) where ipsilateral ECA stenosis was ≥70% irrespectively of the contralateral ICA patency. Ipsilateral external carotid artery stenosis ≥70% proved to be and independent risk factor for symptom presentation (P=0.013).
The study reveals the significant role of ECA patency in cerebral flow in patients with ICA occlusion.
在颈内动脉（ICA）闭塞或严重狭窄的情况下，同侧颈外动脉（ECA）可能为脑血流提供重要的侧支循环途径，可恢复高达15%的大脑中动脉血流。本研究的目的是阐明ECA在完全性ICA闭塞患者脑血流中的作用。
对前瞻性收集的139例完全性ICA闭塞患者的数据进行回顾性研究。将患者分为有症状组和无症状组，并根据狭窄率分为四个亚组：A）同侧ECA<70%且对侧颈内动脉狭窄<70%；B）同侧ECA狭窄<70%且对侧颈内动脉狭窄≥70%；C）同侧ECA狭窄≥70%且对侧ICA狭窄<70%；D）同侧ECA狭窄≥70%且对侧ICA狭窄≥75%。
58例（41.7%）患者无症状。无症状患者比例最高（48.2%）的是A组。在中风患者中，比例最高的是C组和D组（分别为44.4%和50%），其中同侧ECA狭窄≥70%，与对侧ICA通畅情况无关。同侧颈外动脉狭窄≥70%被证明是症状出现的独立危险因素（P = 0.013）。
该研究揭示了ECA通畅在ICA闭塞患者脑血流中的重要作用。
