Carotid artery stenting improves cerebral hemodynamics regardless of the flow direction of ophthalmic artery
Journal
Angiology
Journal Volume
66
Journal Issue
2
Pages
180-186
Date Issued
2015
Author(s)
Liu, Chi-Hung; Chang, Chien-Hung; Chang, Ting-Yu; Huang, Kuo-Lun; Lin, Jr-Rung; Chen, Yu-Wei; Ryu, Shan-Jin; Chang, Yeu-Jhy; Lee, Tsong-Hai
Abstract
We enrolled 221 patients with elective carotid artery stenting (CAS). Patients with contralateral carotid stenosis exceeding 50%, insufficient vertebral artery (VA) flows, or angioplasty at subclavian artery were excluded. All patients underwent serial cerebral ultrasound studies. Of the 116 included patients, the direction of ophthalmic artery (OA) flow was forward in 74 patients while reversed in 42. The reversed flow group had worse ipsilateral stenosis, higher hemoglobin, and cardiac output. After CAS, the reversed flow group had an immediate recovery of ipsilateral internal carotid artery flow volume (FV; P < .0001), time average velocity (TAV) of middle cerebral artery (P = .02), and normalization of OA flow. The forward flow group had gradual decrement in TAV of contralateral anterior cerebral artery (P = .01) and total FV of VA (P = .001). Our results suggest CAS improves cerebral hemodynamics through different ways regardless of the direction of OA flow. ? The Author(s) 2014.
Subjects
Carotid artery stenting; Carotid ultrasound; Collateral circulation; Ophthalmic artery; Transcranial doppler
SDGs
Other Subjects
acetylsalicylic acid; clopidogrel; hemoglobin; adult; aged; anterior cerebral artery; anticoagulant therapy; artery blood flow; Article; blood flow velocity; brain blood flow; brain blood volume; brain ischemia; carotid artery flow; carotid artery obstruction; carotid artery stent; carotid artery stenting; collateral circulation; controlled study; digital subtraction angiography; echoencephalography; female; heart output; hemoglobin blood level; human; internal carotid artery; major clinical study; male; middle aged; middle cerebral artery; ophthalmic artery; self expandable metallic stent; time average velocity; transient ischemic attack; treatment outcome; vertebral artery; angioplasty; blood flow; brain circulation; Carotid Stenosis; color ultrasound flowmetry; convalescence; devices; Doppler echography; echography; hemodynamics; ophthalmic artery; pathophysiology; predictive value; severity of illness index; stent; Aged; Angioplasty; Carotid Stenosis; Cerebrovascular Circulation; Female; Hemodynamics; Humans; Male; Middle Aged; Middle Cerebral Artery; Ophthalmic Artery; Predictive Value of Tests; Recovery of Function; Regional Blood Flow; Severity of Illness Index; Stents; Treatment Outcome; Ultrasonography, Doppler, Color; Ultrasonography, Doppler, Transcranial
Type
journal article