Sixty-Four-Section CT Cerebral Perfusion Evaluation in Patients with Carotid Artery Stenosis before and after Stenting with a Cerebral Protection Device

• Published in: American journal of neuroradiology : AJNR 2008-05, Vol.29 (5), p.919-923
• Main Authors: Gaudiello, F, Colangelo, V, Bolacchi, F, Melis, M, Gandini, R, Garaci, F.G, Cozzolino, V, Floris, R, Simonetti, G
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Biological and medical sciences; Blood Vessel Prosthesis; Brain; Carotid Stenosis - prevention & control; Carotid Stenosis - surgery; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous; Mood disorders; Nervous system; Prognosis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Reproducibility of Results; Sensitivity and Specificity; Stents; Tomography, X-Ray Computed - methods; Treatment Outcome
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A0945

Brain tissue viability depends on cerebral blood flow (CBF) that has to be kept within a narrow range to avoid the risk of developing ischemia. The aim of the study was to evaluate by 64-section CT (VCT) the cerebral perfusion modifications in patients with severe carotid stenosis before and after undergoing carotid artery stent placement (CAS) with a cerebral protection system. Fifteen patients with unilateral internal carotid stenosis (>or=70%) underwent brain perfusional VCT (PVCT) 5 days before and 1 week after the stent-placement procedure. CBF and mean transit time (MTT) values were measured. Decreased CBF and increased MTT values were observed in the cerebral areas supplied by the stenotic artery as compared with the areas supplied by the contralateral patent artery (P < .001). A significant normalization of the perfusion parameters was observed after the stent-placement procedure (mean pretreatment MTT value, 5.3 +/- 0.2; mean posttreatment MTT value, 4.3 +/- 0.18, P < .001; mean pretreatment CBF value, 41.2 mL/s +/- 2.1; mean posttreatment CBF value, 47.9 mL/s +/- 2.9, P < .001). PVCT is a useful technique for the assessment of the hemodynamic modifications in patients with severe carotid stenosis. The quantitative evaluation of cerebral perfusion makes it a reliable tool for the follow-up of patients who undergo CAS.