Evaluation of cerebral hemodynamic status in patients with unilateral symptomatic carotid artery stenosis during motor tasks, through use of transcranial Doppler sonography

2022 ◽  
Author(s):  
Aysel MILANLIOGLU ◽  
Aslı YAMAN ◽  
Mehmet KOLUKISA ◽  
Talip ASIL
Keyword(s):  
Carotid Artery ◽  
Transcranial Doppler ◽  
Carotid Artery Stenosis ◽  
Doppler Sonography ◽  
Transcranial Doppler Sonography ◽  
Artery Stenosis ◽  
Hemodynamic Parameters ◽  
Motor Tasks ◽  
Symptomatic Carotid ◽  
Group 1

ABSTRACT Background: Carotid artery stenosis increases cerebral ischemic event risk through changing different cerebral hemodynamic parameters. Objective: To investigate how cerebral hemodynamics in the M1 segment of middle cerebral artery change in patients with carotid artery stenosis, after motor tasks using transcranial Doppler sonography (TCD). Methods: Thirty-two healthy subjects and 30 patients with unilateral symptomatic carotid artery stenosis were recruited. The patient population was divided into three groups according to the degree of stenosis (group 1: ≥50 to 69%, group 2: 70 to 89% and group 3: ≥90 to 99%). TCD was used to measure the pulsatility index (PI) and cerebral vasomotor reactivity (CVR). Results: In the patient group, significant differences for symptomatic side PI values (p=0.01) and mean CVR increases (p=0.05) were observed, compared with the healthy controls. However, the difference was not statistically significant for asymptomatic side PI values and mean CVR increases. The results from the intergroup comparison showed significantly higher percentages of symptomatic and asymptomatic side CVR increases in group 1, compared with groups 2 and 3 (p=0.001 and p=0.002, respectively). Conclusions: Our study showed that cerebral autoregulation and hemodynamic mechanisms are impaired in patients with carotid artery stenosis. Furthermore, the impairment of PI and CVR tends to get worse with increasing degrees of stenosis. In addition, this study demonstrated that assessment of these two hemodynamic parameters in clinical practice might be helpful for monitoring the progress of carotid artery stenosis.

Mycophenolate mofetil attenuates plaque inflammation in patients with symptomatic carotid artery stenosis

2010 ◽  
Vol 211 (1) ◽  
pp. 231-236 ◽  
Author(s):  
Sander I. van Leuven ◽  
Diederik F. van Wijk ◽  
Oscar L. Volger ◽  
Jean-Paul P.M. de Vries ◽  
Chris M. van der Loos ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Symptomatic Carotid ◽  
Plaque Inflammation

Abstract 2509: Standardized Reports Are Needed To Describe Carotid Artery Stenosis

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Eric Cheng ◽  
Salomeh Keyhani ◽  
Susan Ofner ◽  
Linda Williams ◽  
Dawn Bravata
Keyword(s):  
Decision Making ◽  
Clinical Trials ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Diagnostic Tests ◽  
Artery Stenosis ◽  
Fiscal Year ◽  
Symptomatic Carotid ◽  
Imaging Results ◽  
Exact Degree

Background: Landmark clinical trials have shown that carotid procedures can greatly reduce the risk of stroke in persons with symptomatic carotid artery stenosis between 70 and 99% and can somewhat reduce the risk of stroke in persons with symptomatic carotid stenosis between 50 and 69%. Guidelines have recommended that results from carotid artery imaging tests be presented in these ranges to facilitate decision-making. We sought to determine how carotid imaging results were reported across Veterans Administration (VA) facilities. Methods: Carotid artery imaging results were obtained as part of a comprehensive chart review of veterans hospitalized with ischemic stroke at 127 VA hospitals in fiscal year 2007. Abstractors recorded the results of carotid ultrasound, MR angiography, CT angiography, or catheter angiography performed in the twelve months prior to admission to six months after admission. We excluded carotid artery imaging reports with results of “no stenosis”, “mild stenosis”, exact degree of stenosis <50%, or any range of stenosis <50% to focus on those reports that would likely inform decisions about carotid procedures. The unit of analysis was the carotid artery. We described how often the results were presented as an exact degree (such as 60%), as a range (such as 50 to 69%), or as a descriptive category (“moderate” or “severe” stenosis). For results described as a range, we examined how often it matched those used in landmark trials. Results: Of 6527 results of carotid artery imaging, there were 1315 results of greater than 50% or at least “moderate stenosis” (see Table ). Only 234 of the reports used a range to describe the stenosis; among this set, only 55 of the reports used a 50-69% or 70-99% range to describe the stenosis. Conclusions: In this national healthcare system, significant carotid artery stenosis was rarely reported in a way that exactly mapped onto recommendations from landmark clinical trials and guidelines. Clinicians who order these diagnostic tests as well as clinicians who interpret these diagnostic tests should collaborate to produce standardized reports that facilitate decision-making.

scholarly journals Periprocedural Thromboembolic Events Associated with Angioplasty and Stenting of the Extra- and Intracranial Carotid Artery Assessed by Neurological Status and Diffusion-Weighted Magnetic Resonance Imaging (DWI)

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Frank Ahlhelm ◽  
Johanna Lieb ◽  
Stefan Ulmer ◽  
Dirk Ahlhelm ◽  
Wolfgang Reith
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Vessel Diameter ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Thromboembolic Events ◽  
Intracranial Stenting ◽  
Symptomatic Carotid ◽  
Diffusion Weighted ◽  
Angioplasty And Stenting

Objective. The purpose of this study was to determine the frequency of thromboembolic events associated with angioplasty and stenting of the carotid artery with special regard to extra- or intracranial localization of stenosis. Methods. Twenty patients with symptomatic intracranial or extracranial internal carotid artery stenosis were treated with stenting and/or angioplasty. In 4 patients stenting was technically not feasible (all in the group with intracranial stenosis). All patients underwent diffusion-weighted imaging (DWI) and neurological examination within 48 hours before and after the procedure to detect periprocedural thrombembolic events. Results. Extracranial carotid angioplasty and stenting (eCAS) was technically feasible and successfull without procedure-related neurological complications in all cases. Intracranial stenting (iCAS) was not feasible in four cases including one patient with a fateful course. Concerning the restoration of the vessel diameter intracranial stenting was not as successful as eCAS, but more effective than balloon angioplasty alone. Incidence of thrombembolic events assessed by DWI was low. The detected periprocedural thrombembolic events were small and clinically silent. Conclusion. The risk of thromboembolic events during the endovascular treatment of symptomatic carotid artery stenosis was rather low for intra- and extracranial stenosis of the ICA in our patient sample, but one fatal course was observed.

Angiographic Patterns and Outcomes Achieved by Proximal Balloon Occlusion in Symptomatic Carotid Artery Stenosis Stenting

2019 ◽  
Vol 30 (2) ◽  
pp. 363-372 ◽  
Author(s):  
Cyril Dargazanli ◽  
Mehdi Mahmoudi ◽  
Matteo Cappucci ◽  
François-Louis Collemiche ◽  
Julien Labreuche ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Balloon Occlusion ◽  
Artery Stenosis ◽  
Symptomatic Carotid
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