Increased Cerebral Artery Atherosclerosis in Korea Table 1. Distribution of Atherosclerosis Location DSA or MRA (n = 1955) DSA (n = 725) Any Severe Any Severe CCA 115 (5.9) 17 (0.9) 56 (7.7) 13 (1.8) Extracranial ICA 732 (37.4) 289 (14.8) 379 (52.3) 171 (23.6) Intracranial ICA 260 (13.3) 83 (4.2) 115 (15.9) 44 (6.1) Branch arteries of the ICA 19 (1.0) 7 (0.4) 10 (1.4) 5 (0.7) ACA 331 (16.9) 125 (6.4) 126 (17.4) 64 (8.8) MCA 865 (44.2) 424 (21.7) 304 (41.9) 193 (26.6) Extracranial VA 528 (27.0) 234 (12.0) 232 (32.0) 135 (18.6) Intracranial VA 312 (16.0) 125 (6.4) 111 (15.3) 57 (7.9) BA 290 (14.8) 80 (4.1) 121 (16.7) 40 (5.5) PICA 39 (2.0) 17 (0.9) 35 (4.8) 17 (2.3) AICA 16 (0.8) 8 (0.4) 13 (1.8) 6 (0.8) SCA 6 (0.3) 2 (0.1) 5 (0.7) 2 (0.3) PCA 445 (22.8) 151 (7.7) 113 (15.6) 57 (7.9) Data are given as the number (percentage) of arteries with atherosclerosis. Branch arteries of the ICA include ophthalmic artery, posterior communicating artery, and anterior choroidal artery. Abbreviations are defined as follows. ACA, Anterior cerebral artery; AICA, Anterior inferior cerebellar artery; BA, Basilar artery; CCA, Common carotid artery; DSA, Digital subtraction angiography; ECA, External carotid artery; ICA, Internal carotid artery; MCA, Middle cerebral artery; MRA, Magnetic resonance angiography; PCA, Posterior cerebral artery; PICA, Posterior inferior cerebellar artery; SCA, Superior cerebellar artery; VA, Vertebral artery. Table 2. Yearly Frequency of Atherosclerosis Year Patient numbeMrRAAn+y*DSA Severe Apr ’99 - Mar ’00 217 135 (62.2) 105 (48.4) Apr ’00 - Mar ’01 128 96 (75.0) 76 (59.4) Apr ’01 - Mar ’02 275 208 (75.6) 139 (50.5) Apr ’02 - Mar ’03 288 211 (73.3) 131 (45.5) Apr ’03 - Mar ’04 216 162 (75.0) 90 (41.7) Apr ’04 - Mar ’05 286 233 (81.5) 136 (47.6) Apr ’05 - Mar ’06 276 237 (85.9) 147 (53.3) Apr ’06 - Mar ’07 269 235 (87.4) 167 (62.1) Data are given as the number (percentage) of patients with atherosclerosis. *p < 0.001, p = 0.042, p = 0.010, §p = 0.077 by Mantel-Haenszel test. Patient number 100 71 102 119 67 102 73 91 DSA Any 79 (79.0) 64 (90.1) 88 (86.3) 99 (83.2) 55 (82.1) 89 (87.3) 70 (95.9) 83 (91.2) Severe§ 60 (60.0) 57 (80.3) 70 (68.6) 81 (68.1) 40 (59.7) 63 (61.8) 61 (83.6) 70 (76.9) The relationship between the number of arterial lesions involved and the year was investigated using Spearman’s rank test. There was a significant trend toward an increase in the number of arterial lesions (r = 0.244, p < 0.001). How- ever, there was no relationship between the number of severe arterial lesions and the year (r = 0.045, p = 0.044). After including patients with PCSE We excluded the patients with PCSE for the analysis because occlusive lesions of the cerebral arteries caused by embolism from the heart are often indistinguishable from those by atherosclerosis. However, the exclusion of patients with PCSE may also result in bias of patient selection and data interpretation since those with PCSE may have con- comitant cerebral atherosclerotic lesions. In addition, exclu- sion of one subtype of stroke group (cardioembolism) may prevent uncovering the features in entire stroke patients. Therefore, we further analyzed the data after including 702 patients with PCSE (total 2,657 patients), and the increas- ing tendency of atherosclerosis was also observed (p < 0.001) (Fig. 2B). Burden of atherosclerosis A total of 5,151 atherosclerotic lesions were found in 1,517 patients with atherosclerosis, 1,763 of which were severe. There were 1,868 lesions in EC portions and 3,283 lesions in IC portions. Of 1,517 patients, 374 (24.7%) patients sho- wed a lesion in only one artery, 311 (20.5%) in two arteries, Yonsei Med J http://www.eymj.org Volume 51 Number 3 May 2010 321