[Collateral supply in patients with severe carotid stenosis].
OBJECTIVE
To determine the collateral supply is sufficiency or not in patients with carotid stenosis.


METHODS
Fifteen consecutive patients with carotid stenosis underwent carotid endarterectomy (CEA). We evaluated the patent collateral pathways through the anterior and posterior communicating arteries or the ophthalmic artery (ACoA; PCoA; OA) with TCD before CEA. A total of 15 subjects were monitored the mean velocity of the ipsilateral middle cerebral artery (mvMCA) by TCD and simultaneously detected stump pressure (SP) after cross clamping carotid artery during the operation.


RESULTS
Three subjects patent anterior communicating artery; 5 cases patent posterior communicating artery; 6 of 15 patent OA. SP > or = 50 mm Hg in 8 cases and SP < 50 mm Hg in 7 patients were detected after cross clamping. The decrease of the ipsilateral mvMCA is less than 30% of baseline in 11 cases. Both TCD preoperatively and SP during CEA indicated collateral blood adequately or not in 9 cases. Results of 12 patients evaluated collateral supply by means of SP and mvMCA changes were common.


CONCLUSIONS
TCD is a useful tool for the evaluation of the sufficiency of collateral circulation in patients with carotid artery severe stenosis, especially monitoring the ipsilateral mvMCA changes during carotid endarterectomy.
Liu
Wen-Hong
WH
Department of Neurology, Peking Shijitan Hospital, Beijing 100038, China.
Yu
Feng
F
Li
Jing
J
Zhang
Fu-Xian
FX
He
Mao-Lin
ML
D000368:Aged; D002339:Carotid Arteries / Q000503:physiopathology; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D002536:Cerebral Arteries / Q000503:physiopathology; D003097:Collateral Circulation; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009880:Ophthalmic Artery / Q000503:physiopathology