Skip to main content
SpringerLink
Log in

More coronary artery stenosis, more cerebral artery stenosis? A simultaneous angiographic study discloses their strong correlation

  • ORIGINAL ARTICLE
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Cerebral artery stenosis (CAS) has the same pathogenesis as coronary artery disease (CAD), but the coexistence of these two diseases has been rarely reported. To detect coexistent CAS in CAD patients, we conducted a study of simultaneous coronary and cerebral angiography. Of the 663 consecutive newly diagnosed CAD patients who had not yet been explored to have CAS, 80 were admitted to undergo angiography of bilateral carotid and vertebral system during the same procedure. We defined significant vascular stenosis, either located intracranially or extracranially, as the lesions of diameter stenosis more than 50%. Association between carotid or vertebral stenosis and their potential risk factors were also analyzed. Of our patients, 18 (22.5%) had significant extracranial vascular stenosis, 14 (17.5%) suffered from intracranial stenosis, and 20 (25%) had both. Only 28 patients (35%) had no significant intracranial or extracranial stenosis. None of the demographic parameters as hypertension or diabetes showed significant differences between the cerebral patent group and the CAS group, except for the number of coronary stenotic vessels (1.71 ± 0.81 versus 2.69 ± 0.64, P < 0.001). The number of coronary stenotic vessels is correlated well to the number of cerebral stenotic lesions (r = 0.562, P < 0.001). Besides, 8 of the cerebral stenotic patients and 2 of the cerebral patent patients had ischemic stroke previously. We conclude the CAS is coexistent in more than half of the CAD patients in this study. Our study also implies a proportional increase in the severity of CAS to CAD severity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. MI Chimowitz DG Weiss SL Cohen MR Starling RW Hobson Suffix2nd (1994) ArticleTitleCardiac prognosis of patients with carotid stenosis and no history of coronary artery disease. Veterans Affairs Cooperative Study Group 167 Stroke 25 759–765 Occurrence Handle8160217 Occurrence Handle1:STN:280:DyaK2c3ht1eqsA%3D%3D

    PubMed  CAS  Google Scholar 

  2. S Urbinati G Di Pasquale A Andreoli AM Lusa M Ruffini G Lanzino G Pinelli (1992) ArticleTitleFrequency and prognostic significance of silent coronary artery disease in patients with cerebral ischemia undergoing carotid endarterectomy Am J Cardiol 69 1169–1170 Occurrence Handle10.1016/0002-9149(92)90930-W

    Article  Google Scholar 

  3. Y Suematsu K Nakano Y Sasako J Kobayashi S Kitamura S Takamoto (2000) ArticleTitleConventional coronary artery bypass grafting in patients with total occlusion of the internal carotid artery Heart Vessels 15 256–262 Occurrence Handle11766062 Occurrence Handle10.1007/s003800070002 Occurrence Handle1:STN:280:DC%2BD38%2FjvVOrtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. NR Hertzer JR Young EG Beven RA Graor PJ O'Hara WF Ruschhaupt Suffix3rd VG deWolfe LC Maljovec (1985) ArticleTitleCoronary angiography in 506 patients with extracranial cerebrovascular disease Arch Intern Med 145 849–852 Occurrence Handle3994461 Occurrence Handle10.1001/archinte.145.5.849 Occurrence Handle1:STN:280:DyaL2M7pvVWrtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. Y Nagai EJ Metter CJ Earley MK Kemper LC Becker EG Lakatta JL Fleg (1998) ArticleTitleIncreased carotid artery intima-medial thickness in asymptomatic older subjects with exercise-induced myocardial ischemia Circulation 98 1504–1509 Occurrence Handle9769303 Occurrence Handle1:STN:280:DyaK1cvktlCqtQ%3D%3D

    PubMed  CAS  Google Scholar 

  6. JL Wofford FR Kahl GR Howard WM McKinney JF Toole JR Crouse Suffix3rd (1991) ArticleTitleRelation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis Arterioscler Thromb 11 1786–1794 Occurrence Handle1931880 Occurrence Handle1:STN:280:DyaK38%2FjtFemug%3D%3D

    PubMed  CAS  Google Scholar 

  7. I Christou RA Felberg AM Demchuk JC Grotta WS Burgin M Malkoff AV Alexandrov (2001) ArticleTitleA broad diagnostic battery for bedside transcranial Doppler to detect flow changes with internal carotid stenosis or occlusion J Neuroimaging 11 236–242 Occurrence Handle11462288 Occurrence Handle1:STN:280:DC%2BD3MvhtlCqtg%3D%3D Occurrence Handle10.1111/j.1552-6569.2001.tb00040.x

    Article  PubMed  CAS  Google Scholar 

  8. AI Tomanek SB Coutts AM Demchuk ME Hudon WE Morrish RJ Sevick JE Simon R Frayne AM Buchan MD Hill (2006) ArticleTitleMR angiography compared to conventional selective angiography in acute stroke Can J Neurol Sci 33 58–62 Occurrence Handle16583723

    PubMed  Google Scholar 

  9. S Bash JP Villablanca R Jahan G Duckwiler M Tillis C Kidwell J Saver J Sayre (2005) ArticleTitleIntracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography Am J Neuroradiol 26 1012–1021 Occurrence Handle15891154

    PubMed  Google Scholar 

  10. S Yusuf D Zucker P Peduzzi LD Fisher T Takaro JW Kennedy K Davis T Killip E Passamani R Norris (1994) ArticleTitleRelated effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the Coronar Artery Bypass Graft Surgery Trialists Collaboration Lancet 344 563–570 Occurrence Handle7914958 Occurrence Handle10.1016/S0140-6736(94)91963-1 Occurrence Handle1:STN:280:DyaK2czktl2guw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. MI Chimowitz J Kokkinos J Strong MB Brown SR Levine S Silliman MS Pessin E Weichel CA Sila AJ Furlan (1995) ArticleTitleThe Warfarin-Aspirin Symptomatic Intracranial Disease Study Neurology 45 1488–1493 Occurrence Handle7644046 Occurrence Handle1:STN:280:DyaK2MzntFyrtQ%3D%3D

    PubMed  CAS  Google Scholar 

  12. NR Hertzer EG Beven JR Young PJ O'Hara RA Graor WF Ruschhaupt Suffix3rd (1984) ArticleTitleIncidental asymptomatic carotid bruits in patients scheduled for peripheral vascular reconstruction: results of cerebral and coronary angiography Surgery 96 535–544 Occurrence Handle6474358 Occurrence Handle1:STN:280:DyaL2czgtVOlsQ%3D%3D

    PubMed  CAS  Google Scholar 

  13. RJ Valentine PA Grayburn EJ Eichhorn SI Myers GP Clagett (1994) ArticleTitleCoronary artery disease is highly prevalent among patients with premature peripheral vascular disease J Vasc Surg 19 668–674 Occurrence Handle8164282 Occurrence Handle1:STN:280:DyaK2c3hslajtw%3D%3D

    PubMed  CAS  Google Scholar 

  14. RS Dieter J Tomasson T Gudjonsson RL Brown M Vitcenda J Einerson PE McBride (2003) ArticleTitleLower extremity peripheral arterial disease in hospitalized patients with coronary artery disease Vasc Med 8 233–236 Occurrence Handle15125482 Occurrence Handle10.1191/1358863x03vm506ra

    Article  PubMed  Google Scholar 

  15. P Spurk B Angelkort P Selter (1989) ArticleTitleIncidence of arteriosclerotic lesions of the carotid arteries in chronic peripheral arterial disease and myocardial infarction Angiology 40 39–44 Occurrence Handle2642670 Occurrence Handle1:STN:280:DyaL1M%2Fos1Ojsw%3D%3D

    PubMed  CAS  Google Scholar 

  16. P Lanzer (2003) ArticleTitleVascular multimorbidity in patients with a documented coronary artery disease Z Kardiol 92 650–659 Occurrence Handle12955412 Occurrence Handle10.1007/s00392-003-0954-z Occurrence Handle1:STN:280:DC%2BD3svhs1ehtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. O Kawarada Y Yokoi N Morioka S Nakata S Higashiue T Mori M Iwahashi A Hatada (2003) ArticleTitleCarotid stenosis and peripheral artery disease in Japanese patients with coronary artery disease undergoing coronary artery bypass grafting Circ J 67 1003–1006 Occurrence Handle14639014 Occurrence Handle10.1253/circj.67.1003

    Article  PubMed  Google Scholar 

  18. DJ Durand BA Perler GS Roseborough MA Grega LM Borowicz SuffixJr WA Baumgartner DD Yuh (2004) ArticleTitleMandatory versus selective preoperative carotid screening: a retrospective analysis Ann Thorac Surg 78 159–166 Occurrence Handle15223422 Occurrence Handle10.1016/j.athoracsur.2004.02.024

    Article  PubMed  Google Scholar 

  19. V Sanguigni M Gallu A Strano (1993) ArticleTitleIncidence of carotid artery atherosclerosis in patients with coronary artery disease Angiology 44 34–38 Occurrence Handle8424583 Occurrence Handle1:STN:280:DyaK3s7ktlWjsQ%3D%3D

    PubMed  CAS  Google Scholar 

  20. CS Thomas F Habib K Varghese MT Abraham NJ Hayat G Cherian (2003) ArticleTitleDisease of proximal part of vertebral artery in patients with coronary artery disease Angiology 54 205–209 Occurrence Handle12678196 Occurrence Handle10.1177/000331970305400210

    Article  PubMed  Google Scholar 

  21. CW Hogue SuffixJr SF Murphy KB Schechtman VG Davila-Roman (1999) ArticleTitleRisk factors for early or delayed stroke after cardiac surgery Circulation 100 642–647 Occurrence Handle10441102

    PubMed  Google Scholar 

  22. DA Bull LA Neumayer GC Hunter J Keksz GK Sethi KE McIntyre VM Bernhard (1993) ArticleTitleRisk factors for stroke in patients undergoing coronary artery bypass grafting Cardiovasc Surg 1 182–185 Occurrence Handle8076023 Occurrence Handle1:STN:280:DyaK2czls1CrtQ%3D%3D

    PubMed  CAS  Google Scholar 

  23. WD Turnipseed HA Berkoff FO Belzer (1980) ArticleTitlePostoperative stroke in cardiac and peripheral vascular disease Ann Surg 192 365–368 Occurrence Handle7416831 Occurrence Handle10.1097/00000658-198009000-00012 Occurrence Handle1:STN:280:DyaL3M%2FitValtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  24. RL Wolman NA Nussmeier A Aggarwal MS Kanchuger GW Roach MF Newman CM Mangano KE Marschall C Ley DM Boisvert GM Ozanne A Herskowitz SH Graham DT Mangano InstitutionalAuthorNamethe Multicenter Study of Perioperative Ischemia (McSPI) Research Group InstitutionalAuthorNamethe Ischemia Research and Education Foundation (IREF) Investigators (1999) ArticleTitleCerebral injury after cardiac surgery identification of a group at extraordinary risk Stroke 30 514–522 Occurrence Handle10066845 Occurrence Handle1:STN:280:DyaK1M7mslKhsg%3D%3D

    PubMed  CAS  Google Scholar 

  25. Y Suematsu Y Sasako J Kobayashi S Kitamura S Takamoto (2000) ArticleTitleConventional coronary artery bypass grafting in patients with total occlusion of the internal carotid artery Heart Vessels 15 256–262 Occurrence Handle11766062 Occurrence Handle10.1007/s003800070002 Occurrence Handle1:STN:280:DC%2BD38%2FjvVOrtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  26. T Uehara M Tabuchi S Kozawa E Mori (2001) ArticleTitleMR angiographic evaluation of carotid and intracranial arteries in Japanese patients scheduled for coronary artery bypass grafting Cerebrovasc Dis 11 341–345 Occurrence Handle11385215 Occurrence Handle10.1159/000047664 Occurrence Handle1:STN:280:DC%2BD38%2FhtF2msQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  27. BW Yoon HJ Bae DW Kang SH Lee KS Hong KB Kim BJ Park JK Roh (2001) ArticleTitleIntracranial cerebral artery disease as a risk factor for central nervous system complications of coronary artery bypasses graft surgery Stroke 32 94–99 Occurrence Handle11136921 Occurrence Handle1:STN:280:DC%2BD3M%2FpsV2qug%3D%3D

    PubMed  CAS  Google Scholar 

  28. HJ Bae BW Yoon DW Kang JS Koo SH Lee KB Kim J Lee JK Roh (2006) ArticleTitleCorrelation of coronary and cerebral atherosclerosis: difference between extracranial and intracranial arteries Cerebrovasc Dis 21 112–119 Occurrence Handle16340186 Occurrence Handle10.1159/000090209

    Article  PubMed  Google Scholar 

  29. JM Lazar BF Uretsky BG Denys PS Reddy PJ Counihan M Ragosta (1995) ArticleTitlePredisposing risk factors and natural history of acute neurologic complications of left-sided cardiac catheterization Am J Cardiol 75 1056–1060 Occurrence Handle7747689 Occurrence Handle10.1016/S0002-9149(99)80724-3 Occurrence Handle1:STN:280:DyaK2M3ms1GgsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  30. G Geroulakos DJ O'Gorman E Kalodiki DJ Sheridan AN Nicolaides (1994) ArticleTitleThe carotid intima-media thickness as a marker of the presence of severe symptomatic coronary artery disease Eur Heart J 15 781–785 Occurrence Handle8088266 Occurrence Handle1:STN:280:DyaK2cznsVensg%3D%3D

    PubMed  CAS  Google Scholar 

  31. RL Sacco DE Kargman Q Gu MC Zamanillo (1995) ArticleTitleRace-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study Stroke 26 14–20 Occurrence Handle7839388 Occurrence Handle1:STN:280:DyaK2M7ktFehtg%3D%3D

    PubMed  CAS  Google Scholar 

  32. TC Su JS Jeng KL Chien FC Sung HC Hsu YT Lee (2001) ArticleTitleHypertension status is the major determinant of carotid atherosclerosis: a community-based study in Taiwan Stroke 32 2265–2271 Occurrence Handle11588311 Occurrence Handle1:STN:280:DC%2BD3MrktFGmug%3D%3D

    PubMed  CAS  Google Scholar 

  33. HM Liu YK Tu PK Yip CT Su (1996) ArticleTitleEvaluation of intracranial and extracranial carotid steno-occlusive diseases in Taiwan Chinese patients with MR angiography: preliminary experience Stroke 27 650–653 Occurrence Handle8614924 Occurrence Handle1:STN:280:DyaK287ot1CjsQ%3D%3D

    PubMed  CAS  Google Scholar 

  34. E Nikolsky R Mehran GD Dangas Z Lasic GS Mintz M Negoita AJ Lansky GW Stone I Moussa S Iyer Y Na JW Moses MB Leon (2004) ArticleTitlePrognostic significance of cerebrovascular and peripheral arterial disease in patients having percutaneous coronary interventions Am J Cardiol 15 1536–1539 Occurrence Handle10.1016/j.amjcard.2004.03.010

    Article  Google Scholar 

  35. MI Chimowitz MJ Lynn H Howlett-Smith BJ Stern VS Hertzberg MR Frankel SR Levine S Chaturvedi SE Kasner CG Benesch CA Sila TG Jovin JG Romano InstitutionalAuthorNameWarfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators (2005) ArticleTitleComparison of warfarin and aspirin for symptomatic intracranial arterial stenosis N Engl J Med 352 1305–1316 Occurrence Handle15800226 Occurrence Handle10.1056/NEJMoa043033 Occurrence Handle1:CAS:528:DC%2BD2MXislCjsLo%3D

    Article  PubMed  CAS  Google Scholar 

  36. AM Fayed CJ White SR Ramee JS Jenkins TJ Collins (2002) ArticleTitleCarotid and cerebral angiography performed by cardiologists: cerebrovascular complications Catheter Cardiovasc Interv 55 277–280 Occurrence Handle11870927 Occurrence Handle10.1002/ccd.10095

    Article  PubMed  Google Scholar 

  37. RA Willinsky SM Taylor K Terbrugge RI Farb G Tomlinson W Montanera (2003) ArticleTitleNeurological complications of cerebral angiography: prospective analysis of 2 899 procedures and review of the literature Radiology 227 524–528 Occurrence Handle10.1148/radiol.2272012071

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiovascular Center, Far Eastern Memorial Hospital, Banchao, Taipei, Taiwan

    Ai-Hsien Li, Yiu-Tong Chu, Lin-Hsue Yang, Kuo-Ching Chen & Shu-Hsun Chu

  2. Medical Engineering Postgraduate Institute, Chung Yuan Christian University, Chung-Li, Taiwan

    Ai-Hsien Li

  3. Min-Sheng General Hospital, Taoyuan, Taiwan

    Ai-Hsien Li

Authors
  1. Ai-Hsien Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yiu-Tong Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lin-Hsue Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kuo-Ching Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shu-Hsun Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ai-Hsien Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, AH., Chu, YT., Yang, LH. et al. More coronary artery stenosis, more cerebral artery stenosis? A simultaneous angiographic study discloses their strong correlation. Heart Vessels 22, 297–302 (2007). https://doi.org/10.1007/s00380-006-0971-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-006-0971-8

Key words

Search

Navigation