Cerebral Hemodynamic Benefits after Contralateral Carotid Artery Stenting in Patients with Internal Carotid Artery Occlusion

Abstract

SUMMARY:CEA contralateral to an ICA occlusion is considered a surgical risk, and CAS may be an alternative for these patients. Our goal was to examine whether CAS improves cerebral hemodynamics on the treated side and on the side of the ICA occlusion, on the basis of measurement of CBF and CVR by using SPECT. The subjects were 8 patients who underwent contralateral CAS. Resting CBF and CVR to acetazolamide were measured by using 123 I-IMP SPECT before and chronically (3-6 months) after CAS. Resting CBF was also measured immediately (Ͻ2 hours) after CAS by using 123 I-IMP SPECT. There were no significant differences in resting CBF in both hemispheres

Carotid Endarterectomy with Routine Shunt for Patients with Contralateral Carotid Occlusion

“…13) Oka showed the improvement of cerebral blood flow during the follow-up of carotid stenosis treatment and further supported the theory of hemodynamic impairment. 18) Increased perfusion instability further highlighted the importance of cerebral protection methods such as shunting.…”

Stroke after carotid endarterectomy

“…H. Oka и соавт. [13] в своем исследовании продемонстрировали, что мозговой кровоток сразу после реваскуляризации ГМ не изменяется на обеих сторонах, однако через некоторое время он заметно возрастает на стороне реконструкции. В то же время при повышении АД в раннем послеоперационном периоде может возникать синдром гиперперфузии [15].…”

Single-stage endovascular treatment in patients with severe extracranial large vessel stenosis and concomitant ipsilateral unruptured intracranial aneurysm

“…Additionally, increased CBF after CAS may cause hyperperfusion syndrome in single-stage treatment. Close monitoring of blood pressure during and after the procedure may prevent the possible risks related to a sudden increase in CBF (24). Another possible issue that may negatively affect cerebral perfusion is hemodynamic depression.…”