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Combined Extracranial and Intracranial Atherosclerosis in Korean Patients
Soo Joo Lee, MD;
Soo-Jin Cho, MD;
Heui-Soo Moon, MD;
Young-Min Shon, MD;
Kwang Ho Lee, MD;
Dong-Ik Kim, MD;
Byung-Boong Lee, MD;
Hong Sik Byun, MD;
Seol-Heui Han, MD;
Chin-Sang Chung, MD
Arch Neurol. 2003;60:1561-1564.
Objectives To evaluate the frequency of intracranial atherosclerosis among patients with steno-occlusive extracranial carotid artery disease and to determine if there are factors related to the combined intracranial atherosclerosis.
Design Cross-sectional study.
Setting A tertiary referral hospital.
Patients We studied 142 consecutive patients who had atherosclerotic steno-occlusive lesions (defined as  30% narrowing of the luminal diameter or occlusion) of an extracranial carotid artery confirmed by conventional angiography. We excluded patients who had potential cardiogenic sources of embolism. Potential vascular risk factors for each patient were obtained from medical records.
Main Outcome Measure We determined the location and severity of atherosclerotic lesions by conventional angiography. We compared the vascular risk factors between patients with steno-occlusive extracranial carotid artery disease alone and patients with combined intracranial atherosclerosis and extracranial carotid artery disease.
Results Intracranial steno-occlusive lesions (30% stenosis or occlusion) were found in 80 patients (56.3%). Of 121 patients with significant (50% stenosis or occlusion) extracranial carotid artery disease, 58 (47.9%) also had significant lesions of intracranial arteries. Univariate and multivariate analyses showed that diabetes mellitus was the only significant factor associated with combined intracranial atherosclerosis in patients with extracranial carotid artery disease.
Conclusions Intracranial atherosclerosis is common in Korean patients with steno-occlusive extracranial carotid artery disease. Diabetes mellitus is associated with intracranial atherosclerosis in patients who had steno-occlusive extracranial carotid artery disease.
From the Departments of Neurology (Drs S. J. Lee, Moon, K. H. Lee, and Chung), Surgery (Drs B.-B. Lee and Kim), and Radiology (Dr Byun), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and the Departments of Neurology, Sejong Hospital, Buchon (Dr Cho); College of Medicine, The Catholic University of Korea, Seoul (Dr Shon); College of Medicine, Chungbuk National University, Cheongju (Dr Han); Seoul Municipal Boramae Hospital, Seoul (Dr S. J. Lee); and Hallym University College of Medicine, Seoul (Dr Cho), South Korea.
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