Improvement of carotid blood flow after carotid endarterectomy—Evaluation using intraoperative ultrasound flow measurement

Objectives: to examine the relationship between the degree of extracranial internal carotid artery (ICA) stenosis and changes in the ipsilateral ICA blood flow after carotid endarterectomy (CEA). Material and Methods: in a prospective study we studied 51 patients with unilateral 60–99% ICA stenosis...

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Veröffentlicht in:European journal of vascular and endovascular surgery 2003-02, Vol.25 (2), p.168-174
Hauptverfasser: Eckstein, H.-H., Eichbaum, M., Klemm, K., Doerfler, A., Ringleb, P., Bruckner, T., Allenberg, J.-R.
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container_end_page 174
container_issue 2
container_start_page 168
container_title European journal of vascular and endovascular surgery
container_volume 25
creator Eckstein, H.-H.
Eichbaum, M.
Klemm, K.
Doerfler, A.
Ringleb, P.
Bruckner, T.
Allenberg, J.-R.
description Objectives: to examine the relationship between the degree of extracranial internal carotid artery (ICA) stenosis and changes in the ipsilateral ICA blood flow after carotid endarterectomy (CEA). Material and Methods: in a prospective study we studied 51 patients with unilateral 60–99% ICA stenosis (median degree 84%, asymptomatic stenosis n = 13, symptomatic stenosis n = 38). The degree of ICA diameter stenosis was determined by ex-vivo plastination of the surgically removed atherosclerotic specimen and video-assessed planimetry. Intraoperative transit time ultrasound flow measurements of the carotid arteries were performed before and after CEA. Blood flow changes were assessed by mathematical approximations. Statistics were done by use of the Wilcoxon signed Rank test. Results: common carotid artery (CCA) and ICA median blood flow increased after CEA from 370 and 130 ml/min to 450 and 282 ml/min, respectively (p
doi_str_mv 10.1053/ejvs.2002.1820
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Material and Methods: in a prospective study we studied 51 patients with unilateral 60–99% ICA stenosis (median degree 84%, asymptomatic stenosis n = 13, symptomatic stenosis n = 38). The degree of ICA diameter stenosis was determined by ex-vivo plastination of the surgically removed atherosclerotic specimen and video-assessed planimetry. Intraoperative transit time ultrasound flow measurements of the carotid arteries were performed before and after CEA. Blood flow changes were assessed by mathematical approximations. Statistics were done by use of the Wilcoxon signed Rank test. Results: common carotid artery (CCA) and ICA median blood flow increased after CEA from 370 and 130 ml/min to 450 and 282 ml/min, respectively (p &lt;.001). The relative increase of ICA blood flow was 5% and 18% for 60–69% and 70–79% ICA stenosis (n.s.) but 70% and 247% for 80–89% and 90–99% stenosis (p &lt;.001 each). Mathematical evaluation (fourth-polynomal function) determined a significant increase of carotid blood flow after CEA in ICA stenosis of ≥82.3%. Conclusions: in the absence of severe contralateral ICA occlusive disease a significant increase of ipsilateral ICA blood flow by CEA can be expected in patients with an ICA stenosis of ≥82.3% (linear degree of stenosis, ECST criteria). 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Material and Methods: in a prospective study we studied 51 patients with unilateral 60–99% ICA stenosis (median degree 84%, asymptomatic stenosis n = 13, symptomatic stenosis n = 38). The degree of ICA diameter stenosis was determined by ex-vivo plastination of the surgically removed atherosclerotic specimen and video-assessed planimetry. Intraoperative transit time ultrasound flow measurements of the carotid arteries were performed before and after CEA. Blood flow changes were assessed by mathematical approximations. Statistics were done by use of the Wilcoxon signed Rank test. Results: common carotid artery (CCA) and ICA median blood flow increased after CEA from 370 and 130 ml/min to 450 and 282 ml/min, respectively (p &lt;.001). The relative increase of ICA blood flow was 5% and 18% for 60–69% and 70–79% ICA stenosis (n.s.) but 70% and 247% for 80–89% and 90–99% stenosis (p &lt;.001 each). Mathematical evaluation (fourth-polynomal function) determined a significant increase of carotid blood flow after CEA in ICA stenosis of ≥82.3%. Conclusions: in the absence of severe contralateral ICA occlusive disease a significant increase of ipsilateral ICA blood flow by CEA can be expected in patients with an ICA stenosis of ≥82.3% (linear degree of stenosis, ECST criteria). 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Material and Methods: in a prospective study we studied 51 patients with unilateral 60–99% ICA stenosis (median degree 84%, asymptomatic stenosis n = 13, symptomatic stenosis n = 38). The degree of ICA diameter stenosis was determined by ex-vivo plastination of the surgically removed atherosclerotic specimen and video-assessed planimetry. Intraoperative transit time ultrasound flow measurements of the carotid arteries were performed before and after CEA. Blood flow changes were assessed by mathematical approximations. Statistics were done by use of the Wilcoxon signed Rank test. Results: common carotid artery (CCA) and ICA median blood flow increased after CEA from 370 and 130 ml/min to 450 and 282 ml/min, respectively (p &lt;.001). The relative increase of ICA blood flow was 5% and 18% for 60–69% and 70–79% ICA stenosis (n.s.) but 70% and 247% for 80–89% and 90–99% stenosis (p &lt;.001 each). Mathematical evaluation (fourth-polynomal function) determined a significant increase of carotid blood flow after CEA in ICA stenosis of ≥82.3%. Conclusions: in the absence of severe contralateral ICA occlusive disease a significant increase of ipsilateral ICA blood flow by CEA can be expected in patients with an ICA stenosis of ≥82.3% (linear degree of stenosis, ECST criteria). Eur J Vasc Endovasc Surg 25, 168–174 (2003)</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>12552480</pmid><doi>10.1053/ejvs.2002.1820</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Blood flow
Blood Flow Velocity - physiology
Carotid Artery, Common - diagnostic imaging
Carotid Artery, Common - physiopathology
Carotid Artery, External - diagnostic imaging
Carotid Artery, External - physiopathology
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - physiopathology
Carotid Artery, Internal - surgery
Carotid endarterectomy
Carotid specimen
Carotid stenosis
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - physiopathology
Carotid Stenosis - surgery
Cerebrovascular Circulation - physiology
Endarterectomy, Carotid - instrumentation
Endarterectomy, Carotid - methods
Humans
Middle Aged
Models, Cardiovascular
Monitoring, Intraoperative - methods
Prospective Studies
Treatment Outcome
Ultrasonography, Interventional - methods
title Improvement of carotid blood flow after carotid endarterectomy—Evaluation using intraoperative ultrasound flow measurement
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