Prevalence of impaired cerebrovascular reserve in patients with symptomatic carotid artery disease.
Cerebrovascular reserve (CVR) was studied in 104 consecutive patients with symptomatic carotid territory disease and ipsilateral internal carotid artery stenosis. Overall, 30 of 104 patients (29 per cent) had impaired CVR. The frequency of CVR impairment increased with the severity of internal carotid artery stenosis: impairment was present in none of 11 patients with stenosis of less than 50 per cent, four of 24 with stenosis of 50-69 per cent, 14 of 41 with stenosis of 70-89 per cent and 12 of 28 with stenosis of 90-99 per cent. Patients presenting with a stroke were significantly more likely to have impaired CVR than those with transient ischaemic attacks and/or amaurosis fugax (odds ratio 3.7 (95 per cent confidence interval (c.i.) 1.5-9.0)), as were those with a residual neurological deficit (odds ratio 4.3 (95 per cent c.i. 1.6-11.5)) and evidence of infarction from computed tomography (odds ratio 3.8 (95 per cent c.i. 1.6-9.4)).
Naylor
A R
AR
Department of Vascular Surgery, Royal Infirmary, Edinburgh, UK.
Merrick
M V
MV
Gillespie
I
I
Sandercock
P A
PA
Warlow
C P
CP
Cull
R E
RE
Griffin
T M
TM
Ruckley
C V
CV
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000503:physiopathology*; D002343:Carotid Artery, Internal / Q000503:physiopathology; D016893:Carotid Stenosis / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D002546:Ischemic Attack, Transient / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies