Cerebrovascular Reserve and Stroke Risk in Patients With Carotid Stenosis or Occlusion: A Systematic Review and Meta-Analysis

Abstract

This study seems like a home run for intensive care unit patients. A simple, relatively inexpensive, and nontoxic procedure can result in a significant reduction in life-threatening bloodstream infections. Although vascular surgery patients were not specifically studied in this investigation, it seems reasonable that the results can be extrapolated to any intensive care unit patient. The authors did not detect methicillin-resistant S aureus or VRE isolates with high-level resistance to chlorhexidine during this study. Nevertheless, potential emergence of resistance to chlorhexidine should be monitored over time in any intensive care unit adopting the strategies purposed in this study.

A3-A3 anastomosis and superficial temporal artery-radial artery graft-A3 bypass to treat bilateral ACA steno-occlusive hemodynamic ischemia with cognitive and executive dysfunction: a technical note

“…Further, the optimal treatment strategy for multiple or bilateral intracranial artery stenosis remains unclear. The present two cases experienced improved vascular reserve postoperatively, which may suggest that the bypass surgery might prevent stroke to a great degree than medical treatment alone [27].…”

Reduced cerebrovascular reserve is associated with an increased risk of postoperative ischemic lesions during carotid artery stenting

“…A meta-analysis of 13 studies, which included a total of 1061 independent CVR tests in 991 patients, showed a positive association between lower CVR and future cerebral ischemic events (OR=3.86) 8. Furthermore, impaired CVR is also a known risk factor for hyperperfusion syndrome after CAS 17.…”

“…A recent meta-analysis showed that reduced CVR is a predictor of future stroke in patients with carotid artery occlusive disease 8. These observations suggest that CVR can be used to predict periprocedural stroke in patients with CAS.…”

Imaging Evaluation of Collaterals in the Brain: Physiology and Clinical Translation

“…A recent meta-analysis found a significant odds ratio of 4 between impairment in CVR and subsequent risk of ischemic disease, in both symptomatic and asymptomatic carotid disease[45]. …”