Evaluation of collateral circulation in patients with internal carotid artery occlusion: A clinical and ultrasonographic multicenter study.

BACKGROUND

Internal carotid artery (ICA) occlusion is the major cause of ischemic stroke. The effect of collateral vessels on cerebral hemodynamics in ICA occlusion remains unclear. This study investigated the correlation between collateral vessels and the peak systolic velocity of the middle cerebral artery (MCA) in patients with ICA occlusion.

METHODS

The relevant collateral vessels included the anterior communicating (ACoA), posterior communicating (PCoA), and internal-external carotid (IECCA) arteries, respectively. Patients with unilateral ICA occlusion ( = 251) underwent transcranial Doppler imaging to detect the peak systolic velocity (PSV) of the MCA and other intracranial arteries. The clinical symptoms were assessed using the National Institutes of Health Stroke Scale (NIHSS).

RESULTS

Patients with ACoA collaterals had significantly higher PSV scores and significantly lower NIHSS scores than those without ACoA collaterals ( < 0.001). Patients without any notable collaterals and those with only IECCA had the lowest PSV and highest NIHSS scores. The PSV and NIHSS scores were negatively correlated ( = -0.566, < 0.001).

CONCLUSION

Collateral circulation patency in unilateral ICA occlusion was closely associated with clinical symptoms, and patients with ACoA collaterals may have favorable outcomes. .