Evaluation of Cerebrovascular Reserve in Patients Undergoing Carotid Artery Stenting and Its Usefulness in Predicting Significant Hemodynamic Changes During Temporary Carotid Occlusion
| Autor: | M Horvath, Miloslav Spacek, P Zimolova, Petr Hájek, Josef Veselka, Cyril Stechovsky |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Ultrasonography Doppler Transcranial Physiology Carotid arteries Hemodynamics 030204 cardiovascular system & hematology Ophthalmic Artery 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests medicine.artery Internal medicine Carotid artery disease medicine Humans Carotid Stenosis Aged business.industry General Medicine Middle Aged medicine.disease Transcranial Doppler Cerebrovascular Circulation Ophthalmic artery Predictive value of tests Middle cerebral artery cardiovascular system Cardiology Female Stents Internal carotid artery business Blood Flow Velocity Carotid Artery Internal 030217 neurology & neurosurgery |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1802-9973 0862-8408 |
| DOI: | 10.33549/physiolres.933077 |
| Popis: | We investigated the usefulness of cerebrovascular reserve (CVR) testing to predict severe hemodynamic changes during proximally protected carotid artery stenting. Of 90 patients referred, 63 eligible underwent complete evaluation of the extent of carotid artery disease and transcranial Doppler ultrasound (TCD) assessment of CVR by means of a breath-holding test and ophthalmic artery flow pattern evaluation. Periprocedural TCD monitoring of the ipsilateral middle cerebral artery flow was performed in 24 patients undergoing proximally protected procedure (requiring induction of flow arrest within internal carotid artery). Abnormal CVR was significantly less common in patients with unilateral compared to bilateral carotid artery disease (26.3 % vs. 76.9 %, p=0.02), while ophthalmic artery flow reversal was rare in patients with unilateral carotid artery disease (2.5 % vs. 42.9 %, p50 %, including 2 patients with normal pre-procedural CVR. Our results suggest that TCD evaluation of CVR is not a reliable predictor of hemodynamic changes induced during proximally protected carotid artery stenting in patients with unilateral carotid artery disease. |
| Databáze: | OpenAIRE |
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