Abstract:

Objective To investigate the effect of vertebral artery (VA) morphological anomaly on the duration of symptoms in patients with posterior circulation TIA. Methods The data of patients with posterior circulation TIA who underwent head and neck DSA or CTA from Chongqing Renji Hospital, University of Chinese Academy of Sciences between October 2015 to March 2018 were retrospectively analyzed. According to the duration of symptoms, patients were divided into three groups: duration of symptoms <10 minutes, 10-59 minutes and ≥60 minutes. The differences of subtypes of VA morphological anomaly were compared among the three groups. The association between morphological anomaly of VA and the duration of symptoms of TIA was determined by multivariable logistic regression analysis. Results A total of 237 patients were included, there were 109 (45.99%), 71 (29.96%), and 57 (24.05%) patients in the group of duration of symptoms <10 minutes, 10-59 minutes and ≥60 minutes, respectively. There were statistical differences in sex and the rate of stenosis ≥50% in VA and basilar artery (P <0.05) among the three groups. For VA morphological anomaly, VA atherosclerotic stenosis among the three groups had statistical difference (P =0.004); while there were no statistical differences in unilateral VA tortuosity, bilateral VA tortuosity, unilateral dominance, unilateral dominance plus tortuosity and origin abnormality among the three groups (all P >0.05). The multivariate logistic regression analysis showed that VA stenosis (OR 2.500, 95%CI 1.381-4.525, P =0.002) and basilar artery stenosis ≥50% (OR 12.066, 95%CI 1.446-100.668, P =0.021)were independent influencing factors for the duration of symptoms of posterior circulation TIA. Conclusions VA stenosis and basilar artery stenosis ≥50% are independent risk factors for the duration of symptoms in posterior circulation TIA.

Key words: Vertebral artery; Morphological anomaly; Transient ischemic attack; Stroke risk

摘要：

目的 探讨椎动脉形态学异常对后循环TIA症状持续时间的影响。 方法 回顾性分析2015年10月-2018年3月在中国科学院大学重庆仁济医院神经内科完成头颈部DSA 或CTA的后循环TIA住院患者临床资料，根据症状持续时间分为<10 min组、10～59 min组和≥60 mi n组， 比较椎动脉形态异常各亚型在3组间的差异。通过多因素Logistic回归分析明确椎动脉形态异常与后 循环TIA症状持续时间之间的关系。 结果 共纳入237例患者，其中症状持续时间<10 min组109例（45.99%）、10～59 min组71例（29.96%） 和≥60 min组57例（24.05%）。一般临床资料的比较显示，性别、椎动脉和基底动脉狭窄率≥50% 在3组间差异具有统计学意义（P＜0.05）。椎动脉形态异常中，动脉粥样硬化性椎动脉狭窄（狭窄 率1%～99%）在3组间的差异具有统计学意义（P =0.004），而一侧迂曲、双侧迂曲、一侧优势、一 侧优势合并迂曲和起源异常在3组间差异均无统计学意义；多因素Logi sti c回归分析显示椎动脉 狭窄（OR 2.500，95%CI 1.381～4.525，P =0.002）、基底动脉狭窄率≥50%（OR 12.066，95%CI 1.446～100.668，P =0.021）是TI A症状持续时间延长的独立影响因素。 结论 椎动脉狭窄和基底动脉狭窄率≥50%是影响后循环TIA症状持续时间延长的独立影响因素。

关键词: 椎动脉; 形态学异常; 短暂性脑缺血发作; 卒中风险