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(Stroke. 1996;27:393-397.)
© 1996 American Heart Association, Inc.

Articles

Asymptomatic Occlusive Lesions of Carotid and Intracranial Arteries in Japanese Patients With Ischemic Heart Disease

Evaluation by Brain Magnetic Resonance Angiography

Toshiyuki Uehara, MD; Masayasu Tabuchi, MD; Takatoshi Hayashi, MD; Hiroyuki Kurogane, MD Atsushi Yamadori, MD

From the Neurology Service (T.U., M.T.) and Division of Cardiology (T.H., H.K.), Hyogo Brain and Heart Center at Himeji, and Division of Disability Science, Tohoku University Graduate School of Medicine, Sendai (A.Y.), Japan.

Correspondence to Toshiyuki Uehara, MD, Neurology Service, Hyogo Brain and Heart Center at Himeji, 520 Saisho-ko, Himeji, 670, Japan.

Background and Purpose The purpose of this study was to elucidate the prevalence and degree of asymptomatic occlusive lesions in the carotid and intracranial arteries in Japanese patients with ischemic heart disease (IHD).

Methods We performed carotid and intracranial MR angiography (MRA) on 67 patients (49 men, 18 women; age range, 40 to 78 years; mean age, 60.1 years) who had received selective coronary angiography for the clinical diagnosis of IHD. On the basis of these images, degree of stenosis in the regions of the bilateral carotid artery bifurcation and five regions of the intracranial arteries, ie, bilateral intracranial portions of the internal carotid arteries and the middle cerebral arteries and the basilar artery were estimated.

Results Stenosis of more than 25% narrowing of the diameter of the target arteries was found in 15 patients (22.4%) in the extracranial carotid arteries and in 11 patients (16.4%) in the intracranial arteries. Most of the stenotic lesions were mild. The incidence of extracranial carotid stenosis and the severity of coronary atherosclerosis showed a significant correlation. The mean age of the patients with intracranial arterial lesions was statistically higher than those without intracranial lesions.

Conclusions Our data suggest that asymptomatic occlusive lesions in the carotid and intracranial arteries are fairly common in Japanese patients with IHD, although the degree of stenosis is relatively mild. Coexistence of carotid atherosclerosis should be suspected in IHD patients with severe coronary atherosclerosis, and the possibility of atherosclerosis in the intracranial arteries should be considered in aged IHD patients.

Key Words: angiography • atherosclerosis • cerebral arteries • coronary artery disease

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