Compensation of diseased vessels and their collateral circulation in patients with ischemic stroke

Objective To observe the compensations of diseased arteries and their collateral circulation in patients with ischemic stroke and explore the relation between compensation of collateral circulation and classification of clinical symptoms (Oxfordshire Community Stroke Project [OCSP] classification) in total or severe infarction cases. Methods Based on OCSP classification, we performed digital subtraction angiography (DSA) on 211 patients with cerebral infarction to identify the existence of diseased arteries and their collateral circulations, and the appearance of their compensations. Results one hundred and ninety-eight patients were identified as having diseased arteries with a total number of 206, including 98 internal carotid arteries (ICAs), 54 middle cerebral arteries (MCAs), 27 vertebral arteries (VAs), 6 common carotid arteries (CCAs), 5 basilar arteries (BAs), 4 subclavian arteries (SCAs) and 4 other arteries. Leptomeningeal anastomose compensated 115 arteries, Willis circle compensated 98, and the other 46 were compensated by external-cranium arteries. Conclusions ICAs and MCAs are the firstly involved arteries in patients with cerebral infarction, followed by VAs. Anterior circulation arteries lesions arouse more cerebral infarctions than posterior circulation arteries lesions do. Compensation by Willis circle is the most sufficient type in ischemic stroke cases;while compensation by Leptomeningeal anastomose is the most frequent one. The classification of cerebral infarction is mainly affected by the compensations of diseased arteries and collateral circulation. Key words: Ischemic stroke; Collateral circulation; OCSP classification