title: Peritherapeutic Hemodynamic Changes of Carotid Stenting Evaluated with Quantitative DSA in Patients with Carotid Stenosis.
abstract: OBJECTIVE
  Quantitative data from DSA have become important tools for understanding hemodynamic changes of intracranial lesions. In this study, we evaluated 8 hemodynamic parameters in patients before and after carotid artery angioplasty.
  
  
  METHODS
  DSA images of 34 patients with carotid stenosis who underwent angioplasty and stent placement were retrospectively analyzed. Eleven ROIs (M1, M2, A1, A2, the parietal vein, superior sagittal sinus, internal jugular vein, and 4 in the ICA) were selected on color-coded DSA. Eight hemodynamic parameters (bolus arrival time, TTP, relative TTP, full width at half maximum, wash-in slope, washout slope, maximum enhancement, and area under the curve) were measured from the time-concentration curves of these ROIs. The dependentttest for paired samples was applied to these parameters before and after stent placement.
  
  
  RESULTS
  We found that the treatment significantly reduced TTP, relative TTP, bolus arrival time, and washout slope at all arterial ROIs and full width at half maximum and area under the curve at some arterial ROIs. Bolus arrival time was significantly reduced after treatment for all arterial ROIs, the parietal vein, and the superior sagittal sinus. The maximum enhancement and wash-in slope did not show significant changes after treatment. After treatment, the relative TTP from the ICA to M1, M2, and the parietal vein returned to normal values.
  
  
  CONCLUSIONS
  In addition to TTP and relative TTP, other parameters can be used to evaluate peritherapeutic cerebral hemodynamic changes. Bolus arrival time has the potential to evaluate brain circulation at arterial and venous sites, especially when TTP cannot be measured because of an incomplete time-concentration curve.
authors.affiliation: From the Department of Medical Imaging (M.M.H.T.), Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: M M H
authors.identifier: http://orcid.org/0000-0002-3929-0178
authors.initials: MMH
authors.lastname: Teng
authors.affiliation: Department of Radiology (F.-C.C., C.-J.L., L.C.), Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine (F.-C.C., C.-J.L.).
authors.forename: F-C
authors.identifier: http://orcid.org/0000-0002-9244-3399
authors.initials: FC
authors.lastname: Chang
authors.affiliation: Department of Radiology (F.-C.C., C.-J.L., L.C.), Taipei Veterans General Hospital, Taipei, Taiwan bcjlin@gmail.com yhkao@ym.edu.tw.|School of Medicine (F.-C.C., C.-J.L.).
authors.forename: C-J
authors.identifier: http://orcid.org/0000-0003-2370-6316
authors.initials: CJ
authors.lastname: Lin
authors.affiliation: Department of Radiology (F.-C.C., C.-J.L., L.C.), Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: L
authors.identifier: http://orcid.org/0000-0001-5636-7096
authors.initials: L
authors.lastname: Chiang
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences (J.-S.H., Y.-H.K.), National Yang-Ming University, Taipei, Taiwan.
authors.forename: J-S
authors.identifier: http://orcid.org/0000-0001-8066-8841
authors.initials: JS
authors.lastname: Hong
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences (J.-S.H., Y.-H.K.), National Yang-Ming University, Taipei, Taiwan. bcjlin@gmail.com yhkao@ym.edu.tw.
authors.forename: Y-H
authors.identifier: http://orcid.org/0000-0002-4481-9830
authors.initials: YH
authors.lastname: Kao