Analysis of Hemodynamic Changes in Early Stage after Carotid Stenting by Transcranial Doppler—A Preliminary Study

Zhang, Yan; Yang, Min; Niu, Guochen; Zou, Yinghua

doi:10.1016/j.avsg.2017.06.124

Cited by 13 publications

(17 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A preliminary study has demonstrated that significant improvement of ipsilateral MCA-PSV occurs in the early stages after CAS. 15 However, these results were obtained in a mixed clinical group in which multiple risk factors, such as simultaneous bilateral CAS and contralateral ICA occlusion, were documented. 15 The present study is the first to investigate hemodynamic responses at the early (<four hours) post-CAS phase, while excluding the important confounds from the two risk factors and focusing on unilateral stenting of ICA stenosis.…”

Section: Discussionmentioning

confidence: 93%

“…15 However, these results were obtained in a mixed clinical group in which multiple risk factors, such as simultaneous bilateral CAS and contralateral ICA occlusion, were documented. 15 The present study is the first to investigate hemodynamic responses at the early (<four hours) post-CAS phase, while excluding the important confounds from the two risk factors and focusing on unilateral stenting of ICA stenosis. The preliminary investigation found that, even in cases in which unilateral stenosis initially exceeded 90%, there was no significant effect on the change of ipsilateral MCA-PSV after CAS.…”

Section: Discussionmentioning

confidence: 93%

“…In contrast, TCD or TCCD are bedside examinations that can be used for routine clinical monitoring of cerebral hemodynamic changes occurring immediately after CAS. 15 Measurement of the MCA velocities alone can facilitate the TCD examination, and these data can be rapidly acquired. Using TCD or TCCD, this study confirmed that an increase of ipsilateral MCA-PSV in the super early stage after CAS in the unilateral ICA stenosis can be measured in patients with and without NO.…”

Section: Discussionmentioning

confidence: 99%

“…10e14 Cerebral hemodynamic changes in the early stage, which indicates the interval extending to four hours after surgery, can be monitored by transcranial Doppler (TCD). 15 However, there has hitherto been no application of this approach to monitor acute cerebral hemodynamic changes on CAS in patients with NO. Therefore, we studied the super early changes in cerebral hemodynamics after CAS in patients with NO and compared these findings in patients with severe stenosis but without NO.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

Zhang

Yang

Niu

et al. 2019

Annals of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

Background: To evaluate the unclear cerebral hemodynamic variations in patients with and without near occlusion (NO) in hours after carotid artery stenting (CAS) by transcranial Doppler (TCD). Methods: Data of 56 patients (11 patients with carotid artery NO and 45 patients with severe stenosis without NO) who underwent unilateral CAS were analyzed. All patients underwent TCD or transcranial color-code Doppler monitoring before CAS and again at one and three hours after the procedure. We compared bilateral middle cerebral artery peak systolic velocity (MCA-PSV), pulsatility index (PI), and blood pressure (BP) data between the two groups. Results: Ipsilateral MCA-PSV increased relative to baseline in the stenosis group at one hour (97 ± 30 vs. 84 ± 23 cm/s, 16%, P < 0.001) and three hours (96 ± 28 vs. 84 ± 23 cm/s, 15%, P < 0.001) after CAS. Corresponding increases were distinctly higher in the NO group than in the stenosis group at one hour (116 ± 37 vs. 80 ± 29 cm/s, 51%, P < 0.001) and three hours (113 ± 39 vs. 80 ± 29 cm/s, 46%, P ¼ 0.001) after CAS, whereas BP decreased similarly between the two groups. The ipsilateral PI increased postsurgically in both groups, whereas contralateral MCA-PSV was unaltered. Conclusions: CAS can induce a significant increase in PSV and PI in ipsilateral MCA within three hours in patients with NO or severe stenosis but absent NO. The increment of ipsilateral MCA-PSV was greater in patients with NO. TCD can facilitate BP control in the early stage after CAS in patients with NO.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

Zhang

Yang

Niu

et al. 2019

Annals of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…In clinical work, Transcranial Doppler (TCD) is used to detect the stenosis of intracranial artery before CAS [6] , monitor the embolus during CAS [7] and analyze the cerebral hemodynamic changes after CAS [8][9] . Some researchers pointed out that the ischemic brain lesion after CAS could increase the risk of recurrent cerebrovascular events [10] .…”

Section: Introductionmentioning

confidence: 99%

The biochemical markers associated with TCD to evaluate the curative effect after Carotid Artery Stenting

Yuan

Wang

Lei

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction：This study associated the expression of GFAP and S100B in serum with the imaging tools (TCD and DWI) to confirm these cerebral biochemical markers as surrogate outcome methods for evaluating the curative effect after CAS.Methods and materials：72 patients with unilateral carotid stenosis who underwent CAS were enrolled in the operation group. The blood samples of the operation patients were collected on four different time points: T1: the day before operation; T2: 1 day (24 hours) after operation; T3: 3 days (72 hours) after operation; T4: 30 days after operation. The operation patients were performed on the MRI after CAS to evaluate the post-operative lesion and received the TCD to monitor the changes of hemodynamics. 47 patients who were excluded for carotid artery stenosis by DSA were selected as the control group. The blood samples of patients in control group were collected at D1 (before DSA) and D2 (24 hours after DSA). The concentrations of GFAP and S100B in serum were measured with ELISA.Results：(1) The MFV (pre-operation, post-operation, 30 days follow-up: 47.65±17.24, 62.37±18.25, 70.29±16.89; P<0.05) and PI (pre-operation, post-operation, 30 days follow-up: 0.78±0.21, 0.98±0.19, 1.02±0.20; P<0.05) increased significantly in the ipsilateral MCA after CAS. And at 30 days follow-up, the CVR improved significantly (post-operation, 30 days follow-up: 27.47±12.13, 31.92±10.94; P<0.05). Patients with different degrees of stenosis, the more severe stenosis in carotid artery, the more obvious improvement of CVR at the 30 days follow-up. (2) After CAS, the serum concentrations of GFAP and S100B increased to the peak at 24 hour after operation (T2), and then decrease gradually (T2>T3>T4; P < 0.05). Furthermore, the serum concentrations of GFAP (r=0.71, P<0.05) and S100B (r=0.78, P<0.05) correlated positively with CVR at 30 days after CAS. (3) 29/72 patients (40.28%) were shown the emerging hyperintense in DWI after CAS.Conclusion：Our finding proven that the trend of GFAP and S100B in serum after CAS had a positive correlation to the improved hemodynamics which was verified by TCD. We recommend the biochemical markers (GFAP and S100B) associated with TCD to evaluate the curative effect after CAS.

show abstract

TCD Monitoring During Carotid Artery Stenting

Campbell¹,

Bates²

2021

Noninvasive Vascular Diagnosis

View full text Add to dashboard Cite

Analysis of Hemodynamic Changes in Early Stage after Carotid Stenting by Transcranial Doppler—A Preliminary Study

Cited by 13 publications

References 27 publications

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

The biochemical markers associated with TCD to evaluate the curative effect after Carotid Artery Stenting

TCD Monitoring During Carotid Artery Stenting

Contact Info

Product

Resources

About

Analysis of Hemodynamic Changes in Early Stage after Carotid Stenting by Transcranial Doppler—A Preliminary Study

Cited by 13 publications

References 27 publications

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

The&nbsp;biochemical markers associated with TCD to evaluate the curative effect after Carotid Artery Stenting

TCD Monitoring During Carotid Artery Stenting

Contact Info

Product

Resources

About

The biochemical markers associated with TCD to evaluate the curative effect after Carotid Artery Stenting