[Distribution and risk factors of steno-occlusive lesions in patients with ischemic cerebrovascular disease].
OBJECTIVE
To investigate the distribution of atherosclerotic steno-occlusive lesions in Chinese patients with ischemic cerebrovascular disease and the risk factors for occlusive lesions of intracranial and extracranial arteries.


METHODS
583 consecutive patients with ischemic cerebrovascular disease, 449 males and 134 females, aged 18-86, 415 with cerebral infarction and 168 with transient ischemic attack (TIA), underwent angiography. The angiographic findings and relevant clinical; data were analyzed.


RESULTS
Fifty of the 583 patients had normal findings in angiography and 527 had occlusive lesions of different degrees, among which 24.3% had only extracranial artery disease (EAD), 36.8% had only intracranial disease (IAD), and 38.9% had both EAD and IAD. In total the incidence of IAD was 75.6%, higher than that of EAD (63.2%). In the carotid TIA patients the percentage of IAD was significantly higher than that of the EAD (P = 0.005), and in the cerebral infarction patients the percentage of IAD was higher than that of the EAD, but now significantly. In the patients with TIA of vertebrobasilar artery the incidence of IAD was significantly higher than that of the EAD (P < 0.01). The proportion of pure IAD alone was high in patients aged < or =40 was 75.5% with the middle cerebral artery as the most frequently involved site, while the proportion of coexistence of IAD and EAD was high in the middle-aged and old-aged groups (39.4% and 48.0% respectively, P < 0.001) with the origin of internal carotid artery as the commonest site of lesions. Multivariable Logistic regression identified age, diabetes, hyperlipidemia, and coronary artery disease as the independent risk factors for EAD, and hypertension, diabetes, and hyperlipidemia for IAD. The patients with EAD were significantly elder and had an increased frequency of coronary artery disease compared with those with IAD.


CONCLUSIONS
In general, the morbidity of IAD was higher that that of EAD in the Chinese patients with ischemic cerebrovascular disease, and presents symptoms of both extracranial and intracranial arteries; however, pure EAD is not uncommon. The distribution pattern of occlusive disease differs among different groups of patients. The patients with EAD are often elder and have an increased frequency of coronary artery disease.
Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing, China.
Dou
D
Li
Mo-Li
ML
Wang
Shen-Mao
SM
Li
Feng
F
Ling
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002545:Brain Ischemia / Q000453:epidemiology* / Q000473:pathology; D016893:Carotid Stenosis / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000473:pathology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult