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Clinical and angiographic comparison of asymptomatic occlusive cerebrovascular disease
P B Gorelick1, L R Caplan, P Langenberg
1Department of Neurology, Michael Reese Hospital, Chicago, IL 60616.
Insights
Black patients had fewer symptoms but more internal carotid artery lesions, while white patients showed more extracranial disease. Understanding asymptomatic lesion distribution aids cerebrovascular treatment strategies.
Area of Science:
- Neurology
- Vascular Surgery
- Public Health
Background:
- Cerebrovascular disease poses significant health risks.
- Identifying patterns in asymptomatic lesions is crucial for risk stratification.
Purpose of the Study:
- To compare clinical and arteriographic features in patients with symptomatic unilateral carotid territory occlusive disease.
- To determine the frequency and distribution of occlusive arterial lesions in asymptomatic vessels across different demographic groups.
Main Methods:
- Retrospective analysis of 106 patients with symptomatic unilateral carotid territory occlusive disease.
- Comparison of clinical presentation and arteriographic findings between demographic subgroups.
Main Results:
- Black patients (younger, female, Chicago-based) exhibited fewer transient ischemic attacks and myocardial infarcts, less claudication, and more asymptomatic lesions in the supraclinoid internal carotid artery, anterior cerebral artery stem, and middle cerebral artery stem.
- White patients (older, male, New England-based) presented with more frequent and severe asymptomatic occlusive disease in extracranial carotid and vertebral arteries.
Conclusions:
- Demographic factors significantly influence the location and presentation of asymptomatic arterial lesions in cerebrovascular disease.
- Knowledge of these distributions is vital for tailoring diagnostic and therapeutic interventions in patients with occlusive cerebrovascular disease.
Abstract:
We compared clinical and arteriographic features in 106 patients with symptomatic unilateral carotid territory occlusive disease to determine the frequency and distribution of occlusive arterial lesions in asymptomatic vessels. Among black patients who were predominantly from Chicago, young, and female, there were fewer transient ischemic attacks and myocardial infarcts, less claudication, and more asymptomatic lesions of the supraclinoid internal carotid artery, anterior cerebral artery stem, and the middle cerebral artery stem. Among white patients predominantly from New England, elderly, and male, there was more frequent and severe occlusive asymptomatic disease at extracranial carotid and vertebral artery sites. Knowledge of the distribution of asymptomatic lesions will help guide evaluation and treatment strategies for patients with occlusive cerebrovascular disease.