Digital subtraction angiography analysis of guilty artery in ischemic cerebroascular disease

Objective To analyze the occurrence characteristics of stenosis or occlusion in guilty artery in patients with ischemic cerebrovascular disease. Methods The data of digital subtraction angiography （DSA） of 304 patients with ischemic cerebrovascular disease were analyzed retrospectively, in which there were 188 patients with transient ischemic attack （TIA） and 116 patients with cerebral infarction. Guilty arteries were identified, and the length of Stenotic segment and severity of stenosis were measured. Results Of the 304 patients, 227 （74.7%） had cerebral artery stenosis or occlusion. 193 （85.0%） identified guilty arteries, in which 104 （53.9%） were in extracranial artery only, 70 （36.3%） were in intracranial artery only, and 19 （9.8%） were in both intra- and extracranial arteries. The incidence of cerebral artery stenosis or occlusion （97/116, 82.9% ） in the cerebral infarction group yeas significantly higher than that in the TIA group （130/188, 68.8%） （P 〈0.01）; the incidence of extracranial vascular lesions in posterior circulation in the TIA group was significantly higher than that in the cerebral infarction group （24.3% vs. 7.0%, P 〈 0.01）; and the incidence of intracranial vascular lesions in anterior circulation in the cerebral infarction group was significantly higher than that in the TIA group （32.6% vs. 20.6%, P 〈0.01 ）. Howeuer, there was no significant difference between the TIA group and the cerebral infarction group in the length of stenosis and severity of guilty artery. Conclusions Cerebral artery stenosis or occlusion in the in the cerebral infarction group is more common than that in the TIA group. The extracranial artery lesions in posterior circulation is more common in the TIA group, and the intracranial artery lesions in anterior circulation is more common in the cerebral infarction group, while the severity of cerebral ischemia is not associated with the stenosis degree and length of guilty artery. Key words: digital subtraction angiography;  cerebral infarction;  ischemic attack, transient;  carotid artery stenosis;  intracranial arterial diseases