title: Intracranial hemodynamic stabilization patterns after stenting of severe stenosis in the proximal internal carotid artery.
abstract: OBJECTIVE
  To evaluate intracranial hemodynamic stabilization patterns after carotid artery stenting (CAS) in patients having variable collateral developments before CAS.
  
  
  METHODS
  The hemodynamic and angiographic data of 62 patients (58 men; mean age 68.0±8.4 years) who underwent CAS for unilateral proximal internal carotid artery stenosis were analyzed. The patients had transcranial Doppler examinations before and at 1 and 90 days after CAS. Patients were classified according to pre-CAS mean blood flow velocity (MBFV) of the ipsilateral middle cerebral artery (MCA): low (<30 cm/s; n=17), normal (30 to 48 cm/s; n=26), or high (>48 cm/s; n=19). The collaterals from contralateral anterior and/or posterior circulations prior to CAS, the stabilization pattern of MBFV, and the pulsatility index (PI) after CAS were compared across the 3 groups.
  
  
  RESULTS
  The presence of collaterals was lowest in the low MBFV group (17.6% of patients) than in the normal (38.5%) or high (68.4%) MBFV groups (p=0.008). The low MBFV group exhibited an increase in MBFV and PI in the ipsilateral MCA at 1 and 90 days after CAS (p<0.05). By contrast, the high MBFV group exhibited a decrease in MBFV and no change in PI in the ipsilateral MCA up to 90 days after CAS (p<0.05). The normal MBFV group showed an increase in MBFV at post-CAS day 1 but a subsequent decrease at 90 days and an increase in PI in the ipsilateral MCA at 1 and 90 days post-CAS (p<0.05).
  
  
  CONCLUSIONS
  The pattern of post-CAS intracranial hemodynamic stabilization differs according to the pre-CAS MBFV in the ipsilateral MCA.
authors.affiliation: Daejeon-Chungnam Regional Cardiovascular and Cerebrovascular Center, Chungnam National University Hospital and School of Medicine, Daejeon, South Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Shin
authors.forename: Hye Seon
authors.initials: HS
authors.lastname: Jeong
authors.forename: Hee-Jung
authors.initials: HJ
authors.lastname: Song
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Si Wan
authors.initials: SW
authors.lastname: Choi
authors.forename: Suk Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Jieun
authors.initials: J
authors.lastname: Shin
authors.forename: Jei
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents