Carotid artery stenting improves cerebral hemodynamics regardless of the flow direction of ophthalmic artery.
We enrolled 221 patients with elective carotid artery stenting (CAS). Patients with contralateral carotid stenosis exceeding 50%, insufficient vertebral artery (VA) flows, or angioplasty at subclavian artery were excluded. All patients underwent serial cerebral ultrasound studies. Of the 116 included patients, the direction of ophthalmic artery (OA) flow was forward in 74 patients while reversed in 42. The reversed flow group had worse ipsilateral stenosis, higher hemoglobin, and cardiac output. After CAS, the reversed flow group had an immediate recovery of ipsilateral internal carotid artery flow volume (FV; P < .0001), time average velocity (TAV) of middle cerebral artery (P = .02), and normalization of OA flow. The forward flow group had gradual decrement in TAV of contralateral anterior cerebral artery (P = .01) and total FV of VA (P = .001). Our results suggest CAS improves cerebral hemodynamics through different ways regardless of the direction of OA flow.
['Liu|Chi-Hung|CH|', 'Chang|Chien-Hung|CH|', 'Chang|Ting-Yu|TY|', 'Huang|Kuo-Lun|KL|', 'Lin|Jr-Rung|JR|', 'Chen|Yu-Wei|YW|', 'Yip|Bak-Sau|BS|', 'Ryu|Shan-Jin|SJ|', 'Chang|Yeu-Jhy|YJ|', 'Lee|Tsong-Hai|TH|']
D000368:Aged D017130:Angioplasty D016893:Carotid Stenosis D002560:Cerebrovascular Circulation D005260:Female D006439:Hemodynamics D006801:Humans D008297:Male D008875:Middle Aged D020768:Middle Cerebral Artery D009880:Ophthalmic Artery D011237:Predictive Value of Tests D020127:Recovery of Function D012039:Regional Blood Flow D012720:Severity of Illness Index D015607:Stents D016896:Treatment Outcome D018615:Ultrasonography, Doppler, Color D017585:Ultrasonography, Doppler, Transcranial
carotid artery stenting ophthalmic artery carotid ultrasound collateral circulation transcranial Doppler