Effect of carotid artery stenting on ocular circulation and chronic ocular ischemic syndrome.
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.
Kawaguchi
Shoichiro
S
Department of Neurosurgery, Nara Medical University, Kashihara, Japan. skawaguc@naramed.-u.ac.jp
Sakaki
Toshisuke
T
Iwahashi
Hideaki
H
Fujimoto
Kenta
K
Iida
Jun-ichi
J
Mishima
Hideaki
H
Nishikawa
Norikiyo
N
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