双侧颈内动脉狭窄的侧枝循环特点分析

Morphologic evaluation of bilateral internal carotid artery stenoses or occlusion

目的 :利用血管造影技术分析双侧颈内动脉狭窄或闭塞的形态学特点。方法 :2 0 0 0年 9月～ 2 0 0 4年 4月 ,我们收治了 15 5例单侧大脑中动脉狭窄或闭塞的患者 ,其中男 10 9例 ,女 4 6例 ;年龄 2 9～ 73岁 ,平均 4 7.6± 6 .2 4岁 ,借助血管造影技术对其形态学特点进行评价。结果 :双侧颈内动脉狭窄或闭塞时 ,最常见各种方式的综合代偿 ,单纯依赖Willis环者较少 ,但在单侧闭塞伴对侧狭窄的患者中 ,前交通动脉代偿较多。单侧闭塞伴对侧狭窄的患者多发生狭窄侧脑梗死。侧枝循环代偿尤其是后交通动脉代偿可以防止梗死发生 ,但前交通动脉代偿时梗死的发生率反而增高。结论 :双侧颈内动脉狭窄或闭塞时 ,应该深入分析血管形态学变化 ,判断其发生缺血事件的危险性 ,从而给予针对性的治疗。

Objective:To evaluate morphologic character of stenoses or occlusion of bilateral internal carotid artery by angiography.Methods:From September 2000 to April 2004,155 patients with stenoses or occlusion of bilateral internal carotid artery were admitted in our department.There were 109 male and 46 female patients.All patients underwent angiography to evaluate their morphologic characters.Results:In bilateral stenoses of internal carotid artery,combined collateral circulation is more often than any type.Anterior communicating artery is the most popular type in occlusion with contralateral severe stenosis.Posterior communicating artery can protect brain from infarction,but anterior communicating artery can be seen as a signal of infarction.Conclusion:In patients with bilateral stenoses of internal carotid artery, morphologic character is important in evaluating patients' status and judging of surgical intervention.