Cerebral perfusion changes in patients with carotid artery stenosis after surgical revascularization
- Authors: Sergeeva A.N.1, Konovalov R.N.1, Sergeev D.V.1, Suslin A.S.1, Skrylev S.I.1, Krotenkova M.V.1, Piradov M.A.1
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Affiliations:
- Research Center of Neurology
- Issue: Vol 8, No 1 (2014)
- Pages: 10-16
- Section: Original articles
- Submitted: 01.02.2017
- Published: 09.02.2017
- URL: https://annaly-nevrologii.com/journal/pathID/article/view/197
- DOI: https://doi.org/10.17816/psaic197
- ID: 197
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Abstract
Assessment of cerebral perfusion and collateral circulation in patients with carotid stenosis might have prognostic value for effective blood flow restoration after carotid revascularization. To evaluate the changes of cerebral perfusion we studied 41 patients with moderate and severe carotid stenosis before and after surgical or endovascular treatment. Perfusion CT at the level of basal ganglia was performed in 17 patients with moderate (50–69%) and 24 patients with severe (70–99%) carotid stenosis for 3 times: before intervention (transluminal angioplasty with stenting or carotid endarterectomy), 3 to 7 days and 1 to 3 months after treatment. Additionally, single CT perfusion study was done in 39 patients without carotid stenosis (control group). We found that surgical recanalization of internal carotid artery may aid restoring cerebral blood flow characteristics in the MCA area to the levels similar to those in control group (namely, decrease of MTT and CBV and increase of CBF). However, in anterior and posterior watershed zones, which are known to be the most vulnerable by chronic hypoperfusion, blood flow normalization was seen only in patients with complete circle of Willis and with moderate carotid stenosis.Thus, prognostic factors for inadequate blood flow restoration in patients with carotid artery stenosis after revascularization include severe stenosis (>70%) and incomplete circle of Willis.
About the authors
Anastasia N. Sergeeva
Research Center of Neurology
Author for correspondence.
Email: sergeevan83@gmail.com
ORCID iD: 0000-0002-2481-4565
Cand. Sci. (Med.), researcher, Radiology department
Russian Federation, 125367, Russia, Moscow, Volokolamskoye shosse, 80Rodion N. Konovalov
Research Center of Neurology
Email: sergeevan83@gmail.com
ORCID iD: 0000-0001-5539-245X
Cand. Sci. (Med.), senior researcher, Neuroradiology department
Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80Dmitry V. Sergeev
Research Center of Neurology
Email: sergeevan83@gmail.com
ORCID iD: 0000-0002-9130-1292
Cand. Sci. (Med.), neurologist, Neurorehabilitation department with TMS group
Russian Federation, 125367, Russia, Moscow, Volokolamskoye shosse, 80Aleksander S. Suslin
Research Center of Neurology
Email: sergeevan83@gmail.com
Russian Federation, Moscow
Sergey I. Skrylev
Research Center of Neurology
Email: sergeevan83@gmail.com
Russian Federation, Moscow
Marina V. Krotenkova
Research Center of Neurology
Email: sergeevan83@gmail.com
ORCID iD: 0000-0003-3820-4554
D. Sci. (Med.), Head, Neuroradiology department
Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80Mikhail A. Piradov
Research Center of Neurology
Email: sergeevan83@gmail.com
ORCID iD: 0000-0002-6338-0392
D. Sci. (Med.), Professor, Full Member of the Russian Academy of Sciences, Director
Russian Federation, MoscowReferences
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