Digital subtraction angiography imaging characteristics of patients with extra-intracranial atherosclerosis and its relationship to stroke.

To investigate the angiographic characteristics and clinical features in patients with suspected extra-intracranial atherosclerosis in a large cohort of Chinese population. On the basis of digital subtraction angiography characteristics, pathological morphology of extra-intracranial atherosclerosis was divided into tortuosity, kinking, coiling, and stenosis in 2,218 individuals aged 45-89 years. The degree of stenosis was further divided into low-grade (<30 %), intermediate-grade (30-69 %), and high-grade stenosis (≥70 %). Clinical manifestations were divided into transient ischemic attack, cerebral infarction and cerebral hemorrhage. The prevalence of tortuosity and stenosis were significantly higher in the extracranial arterial system than that of intracranial arterial system. The prevalence of tortuosity and kinking were significantly higher on the left side than the right side. The prevalence of mild and moderate stenosis in the internal carotid artery was significantly higher in the left side than the right side. The incidence of cerebral infarction was significantly higher in the internal carotid arterial (ICA) system than the vertebrobasilar arterial (VBA) system. Tortuosity is a common carotid abnormality in the Chinese population. The prevalence of ICA tortuosity is higher than that of VBA. The incidence of cerebral infarction in each atherosclerosis group was significantly higher in ICA than that of VBA. The prevalence of stroke is higher in the ICA system than the VBA system. Kinkings and coilings may not have a clinical significance if these lesions are not associated with atheromatous plaques or carotid stenosis.