NATURAL HISTORY AND SURGICAL TREATMENT OF OCCLUSIVE CEREBROVASCULAR DISEASE EVALUATED BY SERIAL ARTERIOGRAPHY

Abstract

Forty-nine patients with occlusive cerebrovascular disease had arteriographic revisualization of 708 sites of atherosclerosis of the cerebral vessels after a mean interval of 25 months. Of these sites, 78 per cent showed no abnormality and a measurable degree of stenosis was present in 157 (22 per cent). When arteriography was repeated in those cases without lesions, 94 per cent remained normal but 6 per cent showed the development of plaques. When arteriography was repeated in cases with plaques present at the initial examination, 78 per cent remained unchanged but 22 per cent had progressed. As might be expected, repeated arteriography after a mean interval of 43 months revealed more new and progressive lesions than were found after a mean interval of 12 months. Certain cases showed marked and rapid progression at multiple vessel sites while other cases showed no progression at all. The status of atherosclerosis of cerebral vessels visualized by arteriography correlated well with the clinical status with a few exceptions, but the longer the follow-up the better the correlation.