| Autor: |
Szarmach A; Second Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland., Małkiewicz MA; Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.; Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland., Zdun-Ryżewska A; Department of Quality of Life Research, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland., Halena G; Department of Cardiovascular Surgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland., Radkowski M; Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland., Dzierżanowski J; Department of Neurosurgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland., Chwojnicki K; Department of Neurology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland., Muc A; Faculty of Electrical Engineering, Gdynia Maritime University, Gdynia, Poland., Damaszko T; Department of Diagnostics Imaging, Ceynowa Hospital, Wejherowo, Poland., Łyźniak P; Second Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland., Piskunowicz M; First Department of Radiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland., Szurowska E; Second Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland., Demkow U; Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, Warsaw, Poland. demkow@litewska.edu.pl., Winklewski PJ; Second Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.; Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.; Department of Clinical Anatomy and Physiology, Faculty of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland. |
| Abstrakt: |
In this study we hypothesized that the alleviation of neurological symptoms long after internal carotid artery (ICA) stenting may be related to sustained improvement of cerebral perfusion. Thirty-four subjects (F/M; 15/19) with >70% stenosis of a single internal carotid artery and neurological symptoms, who underwent a carotid artery stenting procedure, were studied. Brain computed tomography perfusion (CTP) imaging was performed before and 3 years after ICA stenting. The following relative variables were compared: cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), time to peak (rTTP), and permeability surface area product (rPS). A survey also was conducted to compare the patients' clinical symptoms. Overall, we found that a trend toward rMTT decline was the only persisting change after ICA stenting. We then stratified the patients into the subgroups of <2%, 2-5%, and > 5% rMTT decline and found that those with a rMTT decline >2% reported a prominent reduction in subjective clinical symptoms such as headache, dizziness, tinnitus, blurred vision, transient blindness, a sense of gravity of the head, and pain in the eyeballs. We conclude that a shortened mean rMTT, likely reflecting improved cerebral microcirculation, underlies the improvement of neurological symptoms in patients with ICA stenosis. |
