title: Effect of collateral flow patterns on outcome of carotid occlusion.
abstract: The relationship between anatomical configuration of collateral flow and the outcome of the internal carotid artery (ICA) occlusion was analyzed. Sixty-one patients with occlusion of ICA were studied with transcranial Doppler ultrasonography. The authors monitored blood flow velocities in the middle cerebral artery (MCA) ipsilateral to the ICA occlusion during a series of carotid compressions. Blood flow through three major collateral arteries (anterior and posterior communicating arteries and ophthalmic artery) was determined as a residual flow in MCA after each compression. Twelve subjects had asymptomatic occlusion and 46 had stroke; patients with stroke were divided into mild, moderate, and severe stroke groups. Subjects with asymptomatic occlusion had a higher number of patent collateral vessels than severe stroke patients (p < or = 0.001). The same relationship was found between mild and severe stroke patients (p < or = 0.001) and between moderate and severe stroke (p < or = 0.01). Patients with watershed ischemia had a lower number of patent collateral arteries than patients with thromboembolic ischemia as revealed by CT examination (p < or = 0.02). This study demonstrates the crucial role of collateral flow in the stroke pathogenesis and stroke outcome in subjects with extracranial ICA occlusions.
authors.affiliation: University Hospital, Department of Neurology, Medical School of Comenius University, Bratislava, Slovakia.
authors.forename: P
authors.initials: P
authors.lastname: Hedera
authors.forename: J
authors.initials: J
authors.lastname: Bujdáková
authors.forename: P
authors.initials: P
authors.lastname: Traubner
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002343:Carotid Artery, Internal; D002561:Cerebrovascular Disorders / Q000209:etiology*; D003097:Collateral Circulation / Q000502:physiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial