Poststenotic flow and intracranial hemodynamics in patients with carotid stenosis: Transoral carotid ultrasonography study

Masahiro Kamouchi, Kazuhiro Kishikawa, Yasushi Okada, Tooru Inoue, Setsuro Ibayashi, Mitsuo Iida

研究成果: ジャーナルへの寄稿記事

14 引用 (Scopus)

抄録

BACKGROUND AND PURPOSE: In severe carotid stenosis, blood supply via the poststenotic internal carotid artery (ICA) and collateral pathways determine cerebral perfusion. We investigated whether poststenotic flow on transoral carotid ultrasonography (TOCU) is predictive of cerebral hemodynamics. METHODS: Eighty-eight patients with unilateral carotid stenosis underwent TOCU to analyze blood flow velocity and poststenotic diameter of the extracranial ICA. Intracranial collaterals and cerebral hemodynamics were assessed with selective angiography and single photon emission CT. RESULTS: Poststenotic diameter (P < .0001) and velocities (peak systolic velocity [PSV], time-averaged mean velocity [TMV], end-diastolic velocity [EDV]; all P ≤ .009) decreased with stenotic severity. Poststenotic diameter was correlated with PSV (r = 0.36, P = .0005), EDV (r = 0.32, P = .002), and TMV (r = 0.39, P = .0001). Poststenotic flow was significantly lower with collateral pathways than without pathways (P ≤ .02) and significantly decreased as the number of the collaterals increased (P < .0001). Flow <5 mL/s indicated collaterals (81% sensitivity, 80% specificity). When flow was <5 mL/s, the asymmetry index in the middle cerebral artery (MCA) territory was significantly low during rest (P = .003) and after acetazolamide challenge (P = .006). Poststenotic flow velocity was associated with baseline (P = .007) and postacetazolamide (P = .0009) MCA asymmetry indexes. CONCLUSION: Poststenotic ICA flow measured with TOCU reflects collateral flow and cerebral hemodynamics in patients with severe carotid stenosis. This technique may provide new parameters for screening patients with hemodynamically significant carotid stenosis.

元の言語英語
ページ(範囲)76-81
ページ数6
ジャーナルAmerican Journal of Neuroradiology
26
発行部数1
出版物ステータス出版済み - 12 1 2005

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Carotid Stenosis
Ultrasonography
Internal Carotid Artery
Hemodynamics
Middle Cerebral Artery
Acetazolamide
Blood Flow Velocity
Photons
Angiography
Perfusion
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

これを引用

Poststenotic flow and intracranial hemodynamics in patients with carotid stenosis : Transoral carotid ultrasonography study. / Kamouchi, Masahiro; Kishikawa, Kazuhiro; Okada, Yasushi; Inoue, Tooru; Ibayashi, Setsuro; Iida, Mitsuo.

:: American Journal of Neuroradiology, 巻 26, 番号 1, 01.12.2005, p. 76-81.

研究成果: ジャーナルへの寄稿記事

Kamouchi, Masahiro ; Kishikawa, Kazuhiro ; Okada, Yasushi ; Inoue, Tooru ; Ibayashi, Setsuro ; Iida, Mitsuo. / Poststenotic flow and intracranial hemodynamics in patients with carotid stenosis : Transoral carotid ultrasonography study. :: American Journal of Neuroradiology. 2005 ; 巻 26, 番号 1. pp. 76-81.
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abstract = "BACKGROUND AND PURPOSE: In severe carotid stenosis, blood supply via the poststenotic internal carotid artery (ICA) and collateral pathways determine cerebral perfusion. We investigated whether poststenotic flow on transoral carotid ultrasonography (TOCU) is predictive of cerebral hemodynamics. METHODS: Eighty-eight patients with unilateral carotid stenosis underwent TOCU to analyze blood flow velocity and poststenotic diameter of the extracranial ICA. Intracranial collaterals and cerebral hemodynamics were assessed with selective angiography and single photon emission CT. RESULTS: Poststenotic diameter (P < .0001) and velocities (peak systolic velocity [PSV], time-averaged mean velocity [TMV], end-diastolic velocity [EDV]; all P ≤ .009) decreased with stenotic severity. Poststenotic diameter was correlated with PSV (r = 0.36, P = .0005), EDV (r = 0.32, P = .002), and TMV (r = 0.39, P = .0001). Poststenotic flow was significantly lower with collateral pathways than without pathways (P ≤ .02) and significantly decreased as the number of the collaterals increased (P < .0001). Flow <5 mL/s indicated collaterals (81{\%} sensitivity, 80{\%} specificity). When flow was <5 mL/s, the asymmetry index in the middle cerebral artery (MCA) territory was significantly low during rest (P = .003) and after acetazolamide challenge (P = .006). Poststenotic flow velocity was associated with baseline (P = .007) and postacetazolamide (P = .0009) MCA asymmetry indexes. CONCLUSION: Poststenotic ICA flow measured with TOCU reflects collateral flow and cerebral hemodynamics in patients with severe carotid stenosis. This technique may provide new parameters for screening patients with hemodynamically significant carotid stenosis.",
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AU - Kamouchi, Masahiro

AU - Kishikawa, Kazuhiro

AU - Okada, Yasushi

AU - Inoue, Tooru

AU - Ibayashi, Setsuro

AU - Iida, Mitsuo

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N2 - BACKGROUND AND PURPOSE: In severe carotid stenosis, blood supply via the poststenotic internal carotid artery (ICA) and collateral pathways determine cerebral perfusion. We investigated whether poststenotic flow on transoral carotid ultrasonography (TOCU) is predictive of cerebral hemodynamics. METHODS: Eighty-eight patients with unilateral carotid stenosis underwent TOCU to analyze blood flow velocity and poststenotic diameter of the extracranial ICA. Intracranial collaterals and cerebral hemodynamics were assessed with selective angiography and single photon emission CT. RESULTS: Poststenotic diameter (P < .0001) and velocities (peak systolic velocity [PSV], time-averaged mean velocity [TMV], end-diastolic velocity [EDV]; all P ≤ .009) decreased with stenotic severity. Poststenotic diameter was correlated with PSV (r = 0.36, P = .0005), EDV (r = 0.32, P = .002), and TMV (r = 0.39, P = .0001). Poststenotic flow was significantly lower with collateral pathways than without pathways (P ≤ .02) and significantly decreased as the number of the collaterals increased (P < .0001). Flow <5 mL/s indicated collaterals (81% sensitivity, 80% specificity). When flow was <5 mL/s, the asymmetry index in the middle cerebral artery (MCA) territory was significantly low during rest (P = .003) and after acetazolamide challenge (P = .006). Poststenotic flow velocity was associated with baseline (P = .007) and postacetazolamide (P = .0009) MCA asymmetry indexes. CONCLUSION: Poststenotic ICA flow measured with TOCU reflects collateral flow and cerebral hemodynamics in patients with severe carotid stenosis. This technique may provide new parameters for screening patients with hemodynamically significant carotid stenosis.

AB - BACKGROUND AND PURPOSE: In severe carotid stenosis, blood supply via the poststenotic internal carotid artery (ICA) and collateral pathways determine cerebral perfusion. We investigated whether poststenotic flow on transoral carotid ultrasonography (TOCU) is predictive of cerebral hemodynamics. METHODS: Eighty-eight patients with unilateral carotid stenosis underwent TOCU to analyze blood flow velocity and poststenotic diameter of the extracranial ICA. Intracranial collaterals and cerebral hemodynamics were assessed with selective angiography and single photon emission CT. RESULTS: Poststenotic diameter (P < .0001) and velocities (peak systolic velocity [PSV], time-averaged mean velocity [TMV], end-diastolic velocity [EDV]; all P ≤ .009) decreased with stenotic severity. Poststenotic diameter was correlated with PSV (r = 0.36, P = .0005), EDV (r = 0.32, P = .002), and TMV (r = 0.39, P = .0001). Poststenotic flow was significantly lower with collateral pathways than without pathways (P ≤ .02) and significantly decreased as the number of the collaterals increased (P < .0001). Flow <5 mL/s indicated collaterals (81% sensitivity, 80% specificity). When flow was <5 mL/s, the asymmetry index in the middle cerebral artery (MCA) territory was significantly low during rest (P = .003) and after acetazolamide challenge (P = .006). Poststenotic flow velocity was associated with baseline (P = .007) and postacetazolamide (P = .0009) MCA asymmetry indexes. CONCLUSION: Poststenotic ICA flow measured with TOCU reflects collateral flow and cerebral hemodynamics in patients with severe carotid stenosis. This technique may provide new parameters for screening patients with hemodynamically significant carotid stenosis.

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