Hemodynamic and Metabolic Changes After Carotid Endarterectomy in Patients With High-Degree Carotid Artery Stenosis

Combined 1H and 31P MR spectroscopic imaging: impaired energy metabolism in severe carotid stenosis and changes upon treatment

“…No consistent significant changes were observed due to the use of different ratios and different patient cohorts. Impaired energy metabolism as a consequence of severe ICA stenosis was found in a PET study [5]. Thus, 31 P MRS monitoring the main energy metabolites might be the more appropriate method for studying the effect of treatment.…”

“…Further study results suggest that at least some neuropsychological functions improve after the treatment [4]. Positron emission tomography (PET) revealed significant reductions in cerebral blood flow and oxygen metabolic rate values not only in the ipsilateral hemisphere, but also contralateral to the highgrade carotid stenosis with a significant recovery of these variables after CEA [5]. However, the effect of CEA on alterations in hemodynamic parameters remains controversial and only few other studies found significant changes [6][7][8].…”

Decreased Cerebral Perfusion in Carotid Artery Stenosis, Carotid Angioplasty and Its Effects on Cerebral Circulation

“…Other authors have documented this same phenomenon in the intracranial territory on the healthy side (Hino et al, 2005;Ko et al, 2005). The treatment of the carotid artery stenosis cannot explain this phenomenon based solely on hemodynamics (Ko et al, 2005).…”

Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization

“…Poststenotic brain regions are likely to present with altered blood-flow characteristics and, therefore, a reduced vascular reactivity due to poststenotic compensatory vasodilation. 8 After CEA, CBF and oxygen supply increase to normal values, which leads to an amelioration of the metabolic surroundings 13,32 and an almost adequate cerebral autoregulation and brain activation. Therefore, BOLD SCs following surgery are more intense in patients with stroke compared with patients with TIA, in whom the cerebral autoregulation is not maximized before the surgery, indicating a reduced capability of graded autoregulatory response to brain activation.…”

“…[11][12][13] The aim of this study was to determine whether BOLD fMRI can demonstrate impaired CVR during a bimanual motor task and detect postoperative improvement or restoration of an impaired BOLD response. Using subgroup analyses, we tried to elucidate whether factors such as symptoms of the ICA stenosis, age, or degree of stenosis modulate the degree of postoperative BOLD MR imaging response by using the hemisphere supplied by the ICA that did not undergo surgery as a control.…”