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

IF 3 3区医学 Q2 PERIPHERAL VASCULAR DISEASE Vascular Medicine Pub Date : 2024-09-08 DOI:10.1177/1358863X241264759

Ran Liu, Mingjie Gao, Xinyu Zhao

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Abstract

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 (n = 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_MCA scores and significantly lower NIHSS scores than those without ACoA collaterals (p < 0.001). Patients without any notable collaterals and those with only IECCA had the lowest PSV_MCA and highest NIHSS scores. The PSV_MCA and NIHSS scores were negatively correlated (r = -0.566, p < 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. (ClinicalTrials.gov Identifier: NCT02397655).

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颈内动脉闭塞患者侧支循环评估：一项临床和超声多中心研究。

背景：颈内动脉（ICA）闭塞是缺血性中风的主要原因。侧支血管对颈内动脉闭塞时脑血流动力学的影响仍不清楚。本研究探讨了侧支血管与 ICA 闭塞患者大脑中动脉（MCA）收缩速度峰值之间的相关性：相关侧支血管分别包括前交通动脉（ACoA）、后交通动脉（PCoA）和颈内外动脉（IECCA）。单侧ICA闭塞患者（n = 251）接受了经颅多普勒成像，以检测MCA和其他颅内动脉的峰值收缩速度（PSV）。临床症状采用美国国立卫生研究院卒中量表（NIHSS）进行评估：结果：与没有 ACoA 副袢的患者相比，有 ACoA 副袢的患者 PSVMCA 评分明显更高，NIHSS 评分明显更低（P < 0.001）。没有任何明显袢的患者和只有 IECCA 的患者的 PSVMCA 评分最低，NIHSS 评分最高。PSVMCA和NIHSS评分呈负相关（r = -0.566，p < 0.001）：结论：单侧室内动脉闭塞的侧支循环通畅与临床症状密切相关，有 ACoA 侧支的患者可能会有较好的预后。(ClinicalTrials.gov Identifier：NCT02397655）。

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来源期刊

Vascular Medicine 医学-外周血管病

CiteScore

5.70

自引率

5.70%

发文量

158

审稿时长

>12 weeks

期刊介绍： The premier, ISI-ranked journal of vascular medicine. Integrates the latest research in vascular biology with advancements for the practice of vascular medicine and vascular surgery. It features original research and reviews on vascular biology, epidemiology, diagnosis, medical treatment and interventions for vascular disease. A member of the Committee on Publication Ethics (COPE)