The relationship between transient ischemic attack and carotid artery lesion in angiography

Abstract

Transient hemispheric ischemic attack (HTIA) and amaurosis are related to ulcerative and occlusive lesions of internal and external carotid arteries. However, the importance of ulcerative lesions without stenosis in carotid arteries has not been fully understood in previous reports. The author performed carotid angiography 138 times on 123 patients (15 cases underwent bilateral angiography). There were 93 cases of HTIA; 30 cases of amaurosis (with or without HTIA). In all 35 angiographic examinations of patients with amaurosis, ulcerative or occlusive lesions were confirmed in the carotid bifurcation or siphon. Four of them (11%) survived with ulcerative lesions only in the carotid siphon. Among the 103 angiographic images of HTIA patients, 94 (91%) had ulcerative or occlusive lesions at the carotid bifurcation or siphon. Among these patients, 3 cases had isolated lesions in the carotid siphon; 1 case had very small lesions at the carotid bifurcation, and obvious ulcerative lesions in the innominate artery. Carotid arteriography was normal in 9 cases (9%). There were 67 branches (49%) with ulcerative lesions at the bifurcation; 58 branches (42%) with ulcerative lesions combined with stenosis; 9 branches (7%) with ulcerative lesions without stenosis. There are no ulcerative lesions shown on contrast