Longitudinal assessment of cerebral blood flow changes following carotid artery stenting and endarterectomy

2019 ◽  
Vol 124 (7) ◽  
pp. 636-642 ◽  
Author(s):  
Yina Lan ◽  
Jinhao Lyu ◽  
Xiaoxiao Ma ◽  
Lin Ma ◽  
Xin Lou
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Longitudinal Assessment ◽  
Flow Changes

scholarly journals Correlation between Higher Brain Dysfunction and Cerebral Blood Flow after Carotid Artery Stenting

2021 ◽  
Author(s):  
Ryousuke Orimoto ◽  
Eiichi Kobayashi ◽  
Midori Abe ◽  
Akihiko Adachi ◽  
Yoichi Yoshida ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Brain Dysfunction ◽  
Higher Brain Dysfunction

Global Oxygen Extraction Fraction by Blood Sampling to Anticipate Cerebral Hyperperfusion Phenomenon After Carotid Artery Stenting

Neurosurgery ◽  
2014 ◽  
Vol 75 (5) ◽  
pp. 546-551 ◽  
Author(s):  
Tomonori Iwata ◽  
Takahisa Mori ◽  
Yuichi Miyazaki ◽  
Yuhei Tanno ◽  
Shigen Kasakura ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Blood Sampling ◽  
Oxygen Extraction Fraction ◽  
Cerebral Hyperperfusion Syndrome ◽  
Hyperperfusion Syndrome ◽  
Cerebral Hyperperfusion ◽  
Extraction Fraction

Abstract BACKGROUND: Cerebral hyperperfusion syndrome sometimes occurs after carotid revascularization in patients with severe hemodynamic failure. To prevent cerebral hyperperfusion syndrome, cerebral hyperperfusion phenomenon (CHP) must be detected early. Single-photon emission computed tomography (SPECT) is useful for detecting CHP, but it is impractical on a daily basis. A tool with high availability to find CHP is desired. OBJECTIVE: To investigate whether global oxygen extraction fraction (OEF) by a blood sampling method is useful for indicating CHP after carotid artery stenting (CAS). METHODS: When patients underwent elective CAS from September 2010 to August 2012, we performed blood sampling for OEF calculation and SPECT before and immediately after elective CAS. Data were collected prospectively. OEF was calculated from the cerebral arteriovenous oxygen difference. Cerebral blood flow was measured in the affected middle cerebral artery (MCA) territory and in the ipsilateral cerebellum by SPECT. The ratio of MCA to cerebellar activity was defined as cerebral blood flow in the affected MCA territory divided by cerebral blood flow in the ipsilateral cerebellar hemisphere. Probable CHP was defined as ≥10% increase in the ratio of MCA to cerebellar activity after CAS. The relationship between peri-CAS OEF and probable CHP was evaluated. RESULTS: Of the 96 patients enrolled, 92 patients were analyzed. Probable CHP occurred in 17 patients. Post-CAS OEF was related to probable CHP (P < .01), but pre-CAS OEF was not. The receiver-operating characteristic curve showed that the cutoff value was 45% for probable CHP (P < .001). CONCLUSION: An increase in blood sampling OEF immediately after CAS was related to probable CHP; then the oxygen demand should be reduced.

Intracranial Blood Flow Changes After Extracranial Carotid Artery Stenting

Neurosurgery ◽  
2015 ◽  
Vol 76 (3) ◽  
pp. 330-336 ◽  
Author(s):  
Sophia F. Shakur ◽  
Sepideh Amin-Hanjani ◽  
Caroline Bednarski ◽  
Xinjian Du ◽  
Victor A. Aletich ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Univariate Analysis ◽  
Vessel Diameter ◽  
Mean Flow ◽  
Extracranial Carotid Artery ◽  
Flow Changes ◽  
Symptomatic Stenosis

Abstract BACKGROUND: Carotid artery stenting is an endovascular treatment option for patients with extracranial carotid stenosis. However, intracranial blood flow changes following stenting have not been established. OBJECTIVE: To determine the effects of stenting on intracranial blood flow. METHODS: Records of patients who underwent stenting at our institution between 2004 and 2012 and had flow rates obtained pre- and poststenting by the use of quantitative magnetic resonance angiography were retrospectively reviewed. Percentage stenosis, stenosis length, and minimum vessel diameter were measured from cerebral angiography images. RESULTS: Eighteen patients were included. Mean age was 65 years with 67% presenting with symptomatic stenosis. Degree of stenosis ranged from 60% to 90%. Internal carotid artery (ICA) mean flow improved significantly poststenting from 174.9 ± 83.6 mL/min to 250.7 ± 91.2 mL/min (P = .011). Ipsilateral middle cerebral artery (MCA) flow, however, was not significantly altered poststenting (107.8 ± 41.6 mL/min vs 114.3 ± 36.3 mL/min; P = .28). Univariate analysis revealed that improved minimum vessel diameter after stenting, but not percentage stenosis (P = .18) or stenosis length (P = .45), is significantly associated with increased ICA flow (P = .02). However, improved percentage stenosis, stenosis length, minimum vessel diameter, and ICA flow poststenting were not significantly associated with increased MCA flow (P = .64, .38, .13, .37, respectively). CONCLUSION: ICA flow was compromised at baseline, improving 43% on average poststenting. Increased minimum vessel diameter was the factor most significantly associated with increased flow. Conversely, MCA flow was not significantly compromised at baseline nor altered after stenting, suggesting compensatory intracranial collateral supply prestenting that redistributes following ICA revascularization.

scholarly journals New-onset lesions on MRI-DWI and cerebral blood flow changes on 3D-pCASL after carotid artery stenting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wen-Xin Wang ◽  
Ting Wang ◽  
Lin Ma ◽  
Zheng-Hui Sun ◽  
Ge-Sheng Wang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Three Dimensional ◽  
Diffusion Weighted Images ◽  
Parietal Lobes ◽  
Before And After ◽  
Continuous Arterial Spin Labeling ◽  
New Onset

AbstractThis study aimed to investigate the relationship between the new-onset hyperintense lesions on diffusion-weighted images (DWI) and the changes of cerebral blood flow (CBF) before and after carotid artery stenting (CAS) in patients with symptomatic unilateral carotid artery stenosis. Twenty-four patients with symptomatic unilateral carotid stenosis (50–99%) were enrolled. Routine head magnetic resonance imaging and three-dimensional pseudo-continuous arterial spin labeling were taken 7 days before the surgery and for four consecutive days post CAS. While the incidence of new DWI lesions were high (17/24, 70.8%) and 176 lesions were observed among the 17 cases, there was only one subject showing the symptoms. The majority of the lesions were located at the cortex/subcortex of the ipsilateral frontal and parietal lobes (60.8%) with 92.6% of the lesions size being less than 3 mm. The CBFs in this area were significantly higher than that of the temporal lobe on the first 3 days post stenting (p < 0.05). No periprocedural CBF differences were observed between the two groups, however, the micro-embolism group presented decreased relative CBF in frontal and parietal lobes prior to stenting compared with the non-embolism group. The systolic blood pressure in the micro-embolism group at discharge was significantly lower than that at admission. The high incidence rate of micro-embolism in patients receiving CAS may not be the result of direct changes of hemodynamics in the brain but rather the loss of CBF regulation due to long-term hypoperfusion prior to the stenting.

scholarly journals Evaluation of cerebral blood flow by transcranial Doppler after carotid artery stenting

Neurosonology ◽  
2008 ◽  
Vol 21 (1) ◽  
pp. 18-21
Author(s):  
Kei HARADA ◽  
Shoichi KATO ◽  
Hideyuki ISHIHARA ◽  
Tetsu KUROKAWA ◽  
Fumiaki OKA ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Transcranial Doppler ◽  
Carotid Artery Stenting

scholarly journals Isolated Intraventricular Hemorrhage after Carotid Artery Stenting

2021 ◽  
Vol 39 (3) ◽  
pp. 188-191
Author(s):  
Jiyong Shin ◽  
Jihee Ko ◽  
Minju Kim ◽  
Chul-Hoo Kang ◽  
Jay Chol Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Pressure Fluctuation ◽  
Carotid Artery Stenting ◽  
Intraventricular Hemorrhage ◽  
Rare Complication ◽  
Hyperperfusion Syndrome ◽  
Blood Pressure Fluctuation

Cerebral intraventricular hemorrhage (IVH) is an extremely rare complication of carotid artery stenting (CAS). Fully dilated terminal arteries of a chronic, severely stenosed proximal artery could be ruptured by impaired autoregulation of cerebral blood flow. Hyperperfusion syndrome can occur even if there is no blood pressure fluctuation during the CAS. We report a case of an isolated IVH that occurred hours after CAS.

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