Yang Lei, Yu Ling, Qin Wei, Li Yue, Yang Shuna, Li Xuanting, Hu Wenli
Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 Jan 14;12:753877. doi: 10.3389/fneur.2021.753877. eCollection 2021.
Previous studies on the presence of asymmetrical prominent cortical and medullary vessel signs (APCV/APMV) and collateral circulation in patients with internal carotid artery occlusion internal carotid artery occlusion (ICAO) are rare, and the conclusions are inconsistent. Our study aimed to investigate the relationship between the presence of APCV/APMV and collateral circulation in patients with ICAO.
Patients with acute ischemic stroke with ICAO were recruited in this study. All 74 patients were divided into two groups depending on the presence of APCV and APMV. The status of the cerebral arterial circle (CAC) was graded as poor or good. The poor CAC was defined as MCA was invisible. Severe stroke was defined as cerebral watershed infarction (CWI) or territorial infarction (TI). Clinical and radiological markers were compared between these two groups. Logistic regression was used to investigate the association between the APCV/APMV and clinical and radiological markers.
A total of 74 patients with ICAO were enrolled. Forty-three patients (58.1%) presented with an APCV and APMV was found in 35 (47.2%) patients. Compared with patients with non-APCV, patients with APCV had a more severe stroke ( = 0.038) and had a significantly higher incidence of poor CAC ( = 0.022) than those with APCV. Patients with APMV had a more severe stroke ( = 0.001). Logistic regression showed that poor CAC was independently associated with APCV and severe stroke were independently associated with APMV.
Our study demonstrates that poor CAC was independently associated with the presence of the APCV in patients with ICAO. Severe stroke was independently associated with the APMV.
以往关于颈内动脉闭塞(ICAO)患者中不对称性显著皮质和髓质血管征(APCV/APMV)及侧支循环的研究较少,且结论不一致。我们的研究旨在探讨ICAO患者中APCV/APMV的存在与侧支循环之间的关系。
本研究纳入了患有急性缺血性卒中且有ICAO的患者。根据APCV和APMV的存在情况,将所有74例患者分为两组。将脑动脉环(CAC)的状态分为差或好。差的CAC定义为大脑中动脉不可见。严重卒中定义为脑分水岭梗死(CWI)或区域梗死(TI)。比较这两组之间的临床和影像学指标。采用逻辑回归分析来研究APCV/APMV与临床和影像学指标之间的关联。
共纳入74例ICAO患者。43例患者(58.1%)出现APCV,35例患者(47.2%)发现有APMV。与无APCV的患者相比,有APCV的患者卒中更严重(P = 0.038),且差的CAC发生率显著高于无APCV的患者(P = 0.022)。有APMV的患者卒中更严重(P = 0.001)。逻辑回归分析显示,差的CAC与APCV独立相关,严重卒中与APMV独立相关。
我们的研究表明,在ICAO患者中,差的CAC与APCV的存在独立相关。严重卒中与APMV独立相关。