单侧颈内动脉起始部重度狭窄时侧支循环与缺血性脑血管事件的关系

摘要

目的 探讨单侧颈内动脉起始部重度狭窄时各侧支循环代偿出现的概率与缺血性脑血管事件的关系.方法 选择数字减影血管造影术发现单侧颈内动脉起始部狭窄＞70％的患者46例,其中缺血性脑血管事件24例作为症状组；无缺血性脑血管事件22例作为无症状组.观察侧支循环的组成、Willis环是否变异及其组成血管的管径,分析侧支循环与缺血性脑血管事件的关系.结果 Willis环代偿是主要的侧支循环.症状组后环变异率明显高于无症状组(P＜0.05)；症状组前交通动脉的管径明显细于无症状组[(1.36±0.18) mm vs(1.52±0.18) mm,P＜0.01].结论 单侧颈内动脉起始部重度狭窄患者是否出现缺血性脑血管事件与Willis环的代偿完整性有关,Willis环的代偿潜能与Willis环是否存在变异及前交通动脉、后交通动脉的管径有关.%Objective To study the correlation between collateral circulation and ischemic cerebral events in patients with severe stenosis of single internal carotid artery. Methods Forty-six patients with >70% stenosis of single internal carotid artery detected by digital subtraction angiog-raphy were divided into ischemic cerebral event group (symptomatic group, w = 24) and no ischemic cerebral event group(asymptomatic group,w = 22). Composition of collateral circulation,variation of Willis circle,and vascular diameter of Willis circle were observed. Correlation between collateral circulation and ischemic cerebral events was analyzed. Results The compensation of Willis circle was mainly due to major collateral circulation. The variation rate of posterior Willis circle was significantly higher in symptomatic group than in asymptomatic group(P<0. 05). The diame- . Ter of anterior communicating artery was significantly shorter in symptomatic group than in asymptomatic groupCl. 52 + 0. 18 mm vs 1. 36±0. 18 mm,P<0. 01). Conclusion Ischemic cerebral events are correlated with the integrity of Willis circle in patients with severe stenosis of single internal carotid artery. The potential compensation of Willis circle is correlated with the variation of Willis circle and the diameter of anterior and posterior communicating artery.