title: Symptomatic carotid artery occlusion: flow territories of major brain-feeding arteries.
abstract: OBJECTIVE
  To prospectively investigate the extent of flow territories of the contralateral internal carotid artery (ICA) and vertebrobasilar arteries in patients with symptomatic ICA occlusion.
  
  
  METHODS
  Ethics committee approval and informed consent were obtained. Flow territory mapping of the ICA contralateral to the occluded ICA and mapping of the vertebrobasilar arteries were performed by using selective arterial spin-labeling magnetic resonance imaging in 23 functionally independent patients (22 men, one woman; mean age, 58 years +/- 8 [standard deviation]) with symptomatic ICA occlusion. The control group consisted of 68 subjects (57 men, 11 women; mean age, 59 years +/- 9) without hemodynamically significant ICA obstruction. Voxel-based chi(2) testing with Bonferroni correction was performed to analyze significant differences in the extent of the flow territories.
  
  
  RESULTS
  Flow territory maps in patients with symptomatic ICA occlusion showed significant differences in the flow territories of the contralateral ICA and vertebrobasilar arteries compared with those in control subjects (P < .05).
  
  
  CONCLUSIONS
  In functionally independent patients with symptomatic ICA occlusion, the middle cerebral artery flow territory ipsilateral to the occluded ICA is mainly supplied by the vertebrobasilar arteries, whereas the anterior cerebral artery flow territory on the occluded side is mainly supplied by the contralateral ICA.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. p.j.vanlaar@azu.nl
authors.forename: Peter Jan
authors.initials: PJ
authors.lastname: van Laar
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
authors.forename: Catharina J M
authors.initials: CJ
authors.lastname: Klijn
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Matthias J P
authors.initials: MJ
authors.lastname: van Osch
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
mesh_terms: D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000503:physiopathology*; D001488:Basilar Artery / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000503:physiopathology*; D002343:Carotid Artery, Internal / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002941:Circle of Willis / Q000503:physiopathology; D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014711:Vertebral Artery / Q000503:physiopathology