Intracranial Blood Flow Changes in Patients with High-grade Severe Carotid Artery Stenosis after Stenting

• Published in: World neurosurgery 2017-08, Vol.104, p.863-868
• Main Authors: Huang, Lei, MD, Cao, Wenjie, MD PHD, Ge, Liang, MD, Lu, Gang, MD PHD, Zhang, Xiaolong, MD PHD, Geng, Daoying, MD PHD
• Format: Article
• Language: English
• Subjects: Aged; Blood Flow Velocity - physiology; Blood Volume - physiology; Brain - blood supply; Carotid artery stenting; Carotid Stenosis - classification; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - therapy; Cerebral Infarction - classification; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - etiology; Cerebral Infarction - therapy; Circle of Willis; Collateral Circulation - physiology; Computed Tomography Angiography; CT perfusion; Female; Hemodynamics - physiology; High-grade stenosis; Humans; Male; Middle Aged; Neurosurgery; Prospective Studies; Regional Blood Flow - physiology; Stents
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.04.144

Objective We investigated whether the cerebral hemodynamic changes of pre- and poststenting in patients with severe carotid stenosis differ by stenosis grades. Materials and methods We prospectively recruited patients who underwent carotid artery stenting (CAS) after acute ischemic stroke from June 2014 to December 2015. We compared the mean relative cerebral blood flow changes (rCBF) (measured by whole-brain computed tomography [CT] perfusion) pre- and poststenting in patients with high-grade severe stenosis (HGSS 90%-99%) versus patients with low-grade severe stenosis (LGSS 70%-89%). Results Among 24 patients included in the study (mean age 66.2 ± 7.2 years and 91.7% male), 62.5% [15/24] were in the HGSS group and 37.5% [9/24] were in the LGSS group. In the HGSS group, rCBF increased in territories of the anterior cerebral artery (p=0.021), middle cerebral artery (p