title: Carotid artery stenting improves cerebral hemodynamics regardless of the flow direction of ophthalmic artery.
abstract: We enrolled 221 patients with elective carotid artery stenting (CAS). Patients with contralateral carotid stenosis exceeding 50%, insufficient vertebral artery (VA) flows, or angioplasty at subclavian artery were excluded. All patients underwent serial cerebral ultrasound studies. Of the 116 included patients, the direction of ophthalmic artery (OA) flow was forward in 74 patients while reversed in 42. The reversed flow group had worse ipsilateral stenosis, higher hemoglobin, and cardiac output. After CAS, the reversed flow group had an immediate recovery of ipsilateral internal carotid artery flow volume (FV; P < .0001), time average velocity (TAV) of middle cerebral artery (P = .02), and normalization of OA flow. The forward flow group had gradual decrement in TAV of contralateral anterior cerebral artery (P = .01) and total FV of VA (P = .001). Our results suggest CAS improves cerebral hemodynamics through different ways regardless of the direction of OA flow.
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chi-Hung
authors.initials: CH
authors.lastname: Liu
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Chang
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kuo-Lun
authors.initials: KL
authors.lastname: Huang
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taiwan.
authors.forename: Jr-Rung
authors.initials: JR
authors.lastname: Lin
authors.affiliation: Department of Neurology, Landseed Hospital, Taiwan.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Neurology, National Taiwan University Hospital Hsin-chu Branch, Hsinchu, Taiwan.
authors.forename: Bak-Sau
authors.initials: BS
authors.lastname: Yip
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Shan-Jin
authors.initials: SJ
authors.lastname: Ryu
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yeu-Jhy
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan thlee@adm.cgmh.org.tw.
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial
keywords: carotid artery stenting; carotid ultrasound; collateral circulation; ophthalmic artery; transcranial Doppler