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Research ArticleNeurointervention

Hemodynamic Changes of the Cerebral Circulation after Stent-Protected Carotid Angioplasty

Wolf-Dirk Niesen, Michael Rosenkranz, Bernd Eckert, Melanie Meissner, Cornelius Weiller and Ulrich Sliwka
American Journal of Neuroradiology August 2004, 25 (7) 1162-1167;
Wolf-Dirk Niesen
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Michael Rosenkranz
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Bernd Eckert
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Melanie Meissner
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Cornelius Weiller
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Ulrich Sliwka
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Article Figures & Data

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  • Fig 1.
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    Fig 1.

    CBVF before (CBVF pre) and after (CBVF post) interventional obliteration of the ICA. Star indicates P < .05.

  • Fig 2.
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    Fig 2.

    Volume flow in the ipsilateral ICA before (iICA pre) and after (iICA post) SPAC. Stars indicate P < .01.

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    Fig 3.

    Volume flow of the contralateral carotid artery in patients with anterior cross-filling before (cICA pre) and after (cICA post) SPAC and volume flow of the vertebral arteries in patients with posterior collateral flow before (tAV pre) and after (tAV post) the procedure. Stars indicate P < .01.

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    Fig 4.

    rMCA before (rMCA pre) and after (rMCA post) the interventional procedure. Patients with a hemodynamically relevant contralateral ICA lesion were not included in this analysis. Stars indicate P < .01.

    Data presented in Figures 1–4 were obtained by extracranial color-coded duplex sonography.

Tables

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    TABLE 1:

    Patient demographic data, periprocedural symptoms, and procedural success

    FindingNo.
    Sex
     Male20
     Female13
    Vascular risk factors
     Hypertension21
     Diabetes4
     Hyperlipidemia11
     Nicotine use4
    Type of ischemia
     Stroke13
     Transient ischemic attack15
     Amaurosis fugax3
     Asymptomatic3
    Concomitant vasculopathy
     ICA occlusion7
     Vertebral artery occlusion or stenosis6
     ICA stenosis4
     MCA stenosis1
    Residual stenosis
     Yes2
     No32
    Periprocedural symptoms
     None30
     Transient3
     Persistent1
    • View popup
    TABLE 2:

    Collateral pathways

    Type of Collateral FlowNo. of Patients (%)No. after Intervention
    Ophthalmic9(26.5)0
    Anterior cross-flow16(47.1)1
    Posterior10(29.4)0
    Leptomeningeal6(17.6)0
    None or insufficient bone window7(20.6)0
    • View popup
    TABLE 3:

    Hemodynamic data in volunteers and patients before SPAC

    FindingVolunteers*Patients before SPACP Value
    CBVF (mL/min)599.6 ±63.9527.7 ±120.2.027
    Flow volume (mL/min)
     Ipsilateral ICA212.2 ±36.4108.4 ±57.5<.01
     Contralateral ICA212.2 ±36.4295.1 ±61.6.025
     Total vertebral arteries176.2 ±30.1275.1 ±67.9<.001
    • * Healthy volunteers included six men and four women aged 58.2 years ± 10.2.

    • View popup
    TABLE 4:

    Hemodynamic data in volunteers and patients after SPAC

    FindingVolunteersPost SPACP Value
    CBVF (mL/min)599.6 ±63.9571.9 ±100.7>.05
    Flow volume (mL/min)
     Ipsilateral ICA212.2 ±36.4185.9 ±75.2>.05
     Contralateral ICA212.2 ±36.4273.6 ±65.7.02
     Total vertebral arteries176.2 ±30.1226.1 ±46.2<.01
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American Journal of Neuroradiology: 25 (7)
American Journal of Neuroradiology
Vol. 25, Issue 7
1 Aug 2004
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Cite this article
Wolf-Dirk Niesen, Michael Rosenkranz, Bernd Eckert, Melanie Meissner, Cornelius Weiller, Ulrich Sliwka
Hemodynamic Changes of the Cerebral Circulation after Stent-Protected Carotid Angioplasty
American Journal of Neuroradiology Aug 2004, 25 (7) 1162-1167;

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Hemodynamic Changes of the Cerebral Circulation after Stent-Protected Carotid Angioplasty
Wolf-Dirk Niesen, Michael Rosenkranz, Bernd Eckert, Melanie Meissner, Cornelius Weiller, Ulrich Sliwka
American Journal of Neuroradiology Aug 2004, 25 (7) 1162-1167;
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