Collateral compensative capacity assessment in aged patients with artery occlusion of internal carotid artery system

[Objective] To explore the collateral compensative capacity in aged patients with artery occlusion of internal carotid artery system. [Methods] In 170 aged patients with artery occlusion of internal carotid artery system determined by digital subtraction or MR angiography, the collateral circulation pathway was measured by transcranial Doppler(TCD). [Results] With extracranial internal carotid artery occlusion, TCD showed abnormal middle cerebral artery waveforms (MCAAW) in 68%, blood flow velocity reduction of middle cerebral artery(MCAVR) in 66%, reversed ophthalmic artery (ROA) in 70%, anterior cross-filling via anterior communicating artery (ACoA) in 80%, posterior communicating artery (PCoA) in 71% of patients. With distal internal carotid artery occlusion, TCD showed MCAAW in 90%, MCAVR in 68%, ROA in 15%, ACoA in 51%, PCoA in 61% of patients. With middle cerebral artery occlusion, TCD showed middle cerebral artery flow signal disappearance in 67%, MCAAW and MCAVR in 33%, leptomeningeal anastomoses in 100% of patients. [Conclusions] TCD might furtherly help to know the collateral compensative capacity in patients with artery occlusion of internal carotid artery system. It was suggested that TCD might be important and objective index in evaluating the treatment effect and the prognosis.