Analysis of cerebral angiography in 120 patients with craniocervical artery severe stenosis or occlusion

Objective To investigate the characteristics of cerebral angiography in patients with craniocervical artery severe stenosis or occlusion. Methods The data of cerebral angiography confirmed in 120 patients with craniocervical artery severe stenosis or occlusion were analyzed. They were divided into young （aged 6-44 years, n = 48）, middle-aged （aged 45-59 years, n=41） and elderly （aged ≥60 years, n =31） groups according to their ages. Results There were 324 stenosises or occlusions in all the patients, the intracranial artery stenosis was 47%, extracranial artery stenosis was 35%, and the coexistence of craniocervical artery stenosis was 18%. The proportion of intracranial artery stenosis in the young group （79%） was significantly higher than that in the middle-aged group （29%, P 〈0.01） and that in the elderly group （19%, P 〈0.01）; the proportion of extracranial artery stenosis in the young group （10%） was significantly lower than that in the middle-aged group （46%, P 〈0.01） and that in the elderly group （58%, P 〈0.01 ）; the proportion of artery stenosis in anterior circulation in the young group （97%） was significantly higher than that in the middle-aged group （75%, P 〈0.01） and that in the elderly group （56%, P 〈0.01）. The proportion of intracranial artery stenosis was 35% in patients with cerebral infarction, while extracranial artery stenosis was 42%, and the coexistence of craniocervical artery stenosis was 23% ; the proportion of intracranial artery stenosis in patients with transient ischemic attack （TIA） was 44%, while extracranial artery stenosis was 39%, and the coexistence of craniocervical artery stenosis was 17%. 82% intracerebral hemorrhage and intraventricular hemorrhage occurred in patients with intracranial artery stenosis. A total of 107 patients had cerebral infarct lesions, among them; the infarct lesions of 99 patients were correlated with the stenosis locations. There were some risk factors, such as hypertension, smoking, hyperlipoidemia, advanced age, and diabetes in part of the patients. They had certain relations with the distribution mode of stenosis. Conelusions The most predilection site of cerebral artery stenosis is internal carotid artery. The intracranial artery stenosis is more common in young adults. With the age increasing, the proportion of extracranial artery stenosis is increasing gradually, so is the coexistence of craniocervical artery stenosis. The proportion of artery stenosis in anterior circulation decreases gradually and in posterior circulation increases gradually. The predilection sites are different in artery stenosis in patients with cerebral infarction, TIA, intracerebral hemorrhage and intraventricular hemorrhage. The cerebral infarct lesions in patients with ischemic cerebrovascular disease are closely correlated with their artery stenosis locations. Hypertension has the most impact on the formation of craniocervical artery stenosis in patients, and advanced age and diabetes have greater impact on extracranial artery stenosis. Key words: carotid artery stenosis;  intracranial artery disease;  cerebral angiography; cerebral ischemia