title: Effect of carotid artery stenting on ocular circulation and chronic ocular ischemic syndrome.
abstract: BACKGROUND
  The authors evaluated the effect of carotid artery stenting (CAS) on ocular circulation and chronic ocular ischemic syndrome.
  
  
  METHODS
  We examined 38 patients with carotid artery stenosis (>80%) at its origin treated with CAS. Ocular circulation and symptoms were examined before, within 24 h, and 1 week, 1 month, and 3 months after CAS based on ophthalmic artery color Doppler flow imaging and ophthalmological examinations.
  
  
  RESULTS
  Ocular circulation: Before CAS, 13 patients showed reversed ophthalmic artery flow, and 25 antegrade flow. Average peak systolic flow velocity was -0.038 m/s. Within 24 h after CAS, all patients showed antegrade ophthalmic artery flow; reversed flow before CAS was thus resolved. Average peak systolic flow velocity rose significantly to 0.36 m/s (p < 0.05). One week, 1 month and 3 months after CAS, there were no significant changes compared to the findings at 1 week after CAS. Ocular symptoms: Before CAS, 8 patients showed chronic ocular ischemic syndrome. During the follow-up period (mean: 2.8 years), the visual acuity improved in 7 cases. Average retinal artery pressure and arm-to-retina circulation time improved significantly to the normal level (p < 0.05). The other 30 patients complained of recurrent and worsened visual symptoms during the follow-up period.
  
  
  CONCLUSIONS
  CAS was effective in improving ocular circulation, and also improved the chronic ocular ischemic syndrome caused by the severe carotid artery stenosis.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara, Japan. skawaguc@naramed.-u.ac.jp
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Toshisuke
authors.initials: T
authors.lastname: Sakaki
authors.forename: Hideaki
authors.initials: H
authors.lastname: Iwahashi
authors.forename: Kenta
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Iida
authors.forename: Hideaki
authors.initials: H
authors.lastname: Mishima
authors.forename: Norikiyo
authors.initials: N
authors.lastname: Nishikawa
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D005123:Eye / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography; D012039:Regional Blood Flow; D012044:Regression Analysis; D012161:Retinal Artery / Q000503:physiopathology; D012720:Severity of Illness Index; D015607:Stents; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency; D014656:Vascular Surgical Procedures