title: Effect of carotid artery stenting on ophthalmic artery flow patterns.
abstract: OBJECTIVE
  The purpose of this study was to assess the effect of carotid artery stenting on ophthalmic artery blood flow using transorbital color and spectral Doppler sonography and review the changes in relation to cerebral hemodynamics.
  
  
  METHODS
  Twenty-eight consecutive patients with severe internal carotid artery stenosis (≥ 70%) who were scheduled for carotid stenting were included. Ophthalmic artery Doppler sonography was performed bilaterally before and after stenting. The flow direction, peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index in the ophthalmic artery were recorded.
  
  
  RESULTS
  Twenty male and 8 female patients with 10 right-sided and 18 left-sided stenoses were studied. The mean overall carotid stenosis ratio ± SD was 87.3% ± 9.9%. After stenting in the ophthalmic artery ipsilateral to the stenosis, significant increases in the PSV (-3.87 ± 48.81 to 46.70 ± 25.33 cm/s; P < .001), and EDV (-3.02 ± 16.31 to 11.24 ± 7.37 cm/s; P < .001) were detected, and the increase in the PI approached significance (1.40 ± 0.59 to 1.62 ± 0.52; P = .055). A change in the flow direction from retrograde to antegrade was noted in 11 patients (39%) after stenting, and in 1 patient with no detectable flow, reconstitution of flow was observed. Increases in the PSV and EDV (P= .03 for ΔEDV) were more pronounced in symptomatic patients than asymptomatic patients after stenting.
  
  
  CONCLUSIONS
  Substantially decreased ophthalmic artery velocity and retrograde flow are suggestive of high-grade carotid artery stenosis (≳90%). Stenting improves ophthalmic artery perfusion and positively changes cerebral hemodynamics in high-grade carotid artery stenosis, especially in symptomatic patients, which can be monitored with ophthalmic artery Doppler sonography.
authors.affiliation: Department of Radiology, Ankara University School of Medicine, Ibn-i Sina Hospital, 06230 Ankara, Turkey. namikaltin@gmail.com.
authors.forename: Namik K
authors.initials: NK
authors.lastname: Altinbas
authors.forename: Evren
authors.initials: E
authors.lastname: Ustuner
authors.forename: Hasan
authors.initials: H
authors.lastname: Ozcan
authors.forename: Sadik
authors.initials: S
authors.lastname: Bilgic
authors.forename: Tanzer
authors.initials: T
authors.lastname: Sancak
authors.forename: Ebru
authors.initials: E
authors.lastname: Dusunceli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015607:Stents; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
keywords: carotid artery stenosis; color and spectral Doppler sonography; endovascular treatment; ophthalmic artery; ophthalmologic ultrasound; stenting; stroke