Relationship between transient ischemic attack and intra-and extracranial artery stenosis

Objective To investigate the relationship between transient ischemic attack(TIA)and intra-and extracranial arterial stenosis.Methods The clinical data from 200 patients with TIA who had cerebral angiography were analyzed retrospectively.All the patients were divided into carotid artery system TIA(CA-TIA,n=152)and vertebro-basilar artery system TIA(VB-TIA,n=48)groups according to the clinical manifestation at the onset of the disease.They were divided into frequent TIA(n=123)and non frequent TIA(n=77)groups according to the different attack frequencies;and they also divided into 50 years(n=63),50 to 70 years(n=112)and 70 years(n=65)age groups.The percentage of arterial stenosis was calculated in patients with arterial stenosis.The distribution of intra-and extracranial arterial stenosis of the patients in all groups,between the different attack frequencies,and the occurrence of severe stenosis and occlusion of intra-and extracranial arteries at different age stages were compared.Results ①A total of 175 patients(87.5%,175/200)had intra-and extracranial arterial stenosis in this study.Extracranial artery stenosis were most common in the extracranial segments of internal carotid artery(53.2%,92/173),and the middle cerebral arteries were most common in the intracranial counterparts(39.3%,95/242).The ratio was about 1.4∶1(242/173)between intracranial and extracranial stenotic arteries.②The patients with intracranial arterial stenosis only in the CA-TIA group were more than those in the VB-TIA group(P=0.001),while the patients with extracranial arterial stenosis only in the VB-TIA group were more than those in the CA-TIA group(P=0.006).However,there were no significant difference between them in patients with multiple intra-and extracranial arterial stenosis(P=0.716).③The incidence of the severe intra-and extracranial arterial stenosis or occlusion in the frequent TIA group was higher than that in the non-frequent TIA group(P0.001).Most of the 200 patients with TIA aged 50 to 70 years,and there was a tendency that the incidence of severe stenosis or occlusion increased with age,but there was no significant difference(P0.05).Conclusion Intra-and extracranial arterial stenosis is an important factor for TIA.For the high-risk population,particularly in the aged patients with a history of frequent TIA,it is important to have regular examinations in order to identify intra-and extracranial artery stenosis especially the severe degree of stenosis as early as possible.