Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease
Purpose: The purpose of this study was to determine whether the hemodynamic consequences of extracranial carotid disease correlate with the risk of subsequent cerebral infarction. Methods: In 95 patients with symptoms who had greater than or equal to 70% stenosis (31 patients) or who had occlusion (...
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| Veröffentlicht in: | Journal of vascular surgery 1995-02, Vol.21 (2), p.338-345 |
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| creator | Webster, Marshall W. Makaroun, Michel S. Steed, David L. Smith, Holly A. Johnson, David W. Yonas, Howard |
| description | Purpose: The purpose of this study was to determine whether the hemodynamic consequences of extracranial carotid disease correlate with the risk of subsequent cerebral infarction.
Methods: In 95 patients with symptoms who had greater than or equal to 70% stenosis (31 patients) or who had occlusion (64 patients) of the ipsilateral carotid artery, cerebral blood flow was measured by the stable xenon/computed tomography technique both at baseline and after vasodilatory challenge with intravenous acetazolamide. Patients were stratified into group 1, 43 patients with no more than a 5% decrease in flow in any vascular territory, and group 2, 52 patients with greater than a 5% decrease in one or more vascular territories after an acetazolamide challenge.
Results: In group 2, 15 (28.9%) of 52 patients had a new stroke, but only one (2.3%) of 43 patients in group 1 did (
p = 0.0005). Of patients with total carotid occlusion 10 (26%) of 38 in group 2 and none (0%) of 26 in group 1 had a new stroke (
p = 0.003). Of patients with greater than or equal to 70% stenosis, five (36%) of 14 in group 2 and only one (6%) of 17 in group 1 had a stroke (
p = 0.067).
Conclusion: The loss of cerebral reactivity in patients with symptoms who had greater than or equal to 70% carotid stenosis or occlusion is an important predictor of impending cerebral infarction. (J V
ASC S
URG 1995;21:338-45.) |
| doi_str_mv | 10.1016/S0741-5214(95)70274-1 |
| format | Article |
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Methods: In 95 patients with symptoms who had greater than or equal to 70% stenosis (31 patients) or who had occlusion (64 patients) of the ipsilateral carotid artery, cerebral blood flow was measured by the stable xenon/computed tomography technique both at baseline and after vasodilatory challenge with intravenous acetazolamide. Patients were stratified into group 1, 43 patients with no more than a 5% decrease in flow in any vascular territory, and group 2, 52 patients with greater than a 5% decrease in one or more vascular territories after an acetazolamide challenge.
Results: In group 2, 15 (28.9%) of 52 patients had a new stroke, but only one (2.3%) of 43 patients in group 1 did (
p = 0.0005). Of patients with total carotid occlusion 10 (26%) of 38 in group 2 and none (0%) of 26 in group 1 had a new stroke (
p = 0.003). Of patients with greater than or equal to 70% stenosis, five (36%) of 14 in group 2 and only one (6%) of 17 in group 1 had a stroke (
p = 0.067).
Conclusion: The loss of cerebral reactivity in patients with symptoms who had greater than or equal to 70% carotid stenosis or occlusion is an important predictor of impending cerebral infarction. (J V
ASC S
URG 1995;21:338-45.)</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/S0741-5214(95)70274-1</identifier><identifier>PMID: 7853605</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Acetazolamide - pharmacology ; Adult ; Aged ; Carotid Stenosis - complications ; Carotid Stenosis - diagnostic imaging ; Carotid Stenosis - physiopathology ; Cerebral Arteries - drug effects ; Cerebral Arteries - physiopathology ; Cerebral Infarction - diagnostic imaging ; Cerebral Infarction - etiology ; Cerebral Infarction - physiopathology ; Cerebrovascular Circulation - drug effects ; Cerebrovascular Circulation - physiology ; Cerebrovascular Disorders - diagnostic imaging ; Cerebrovascular Disorders - etiology ; Cerebrovascular Disorders - physiopathology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Forecasting ; Humans ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed - methods ; Vasodilator Agents - pharmacology ; Xenon</subject><ispartof>Journal of vascular surgery, 1995-02, Vol.21 (2), p.338-345</ispartof><rights>1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-4580706c70d8f5914a551516d80def9ac9d6cf3ab508983a9591d663273758233</citedby><cites>FETCH-LOGICAL-c407t-4580706c70d8f5914a551516d80def9ac9d6cf3ab508983a9591d663273758233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0741-5214(95)70274-1$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7853605$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Webster, Marshall W.</creatorcontrib><creatorcontrib>Makaroun, Michel S.</creatorcontrib><creatorcontrib>Steed, David L.</creatorcontrib><creatorcontrib>Smith, Holly A.</creatorcontrib><creatorcontrib>Johnson, David W.</creatorcontrib><creatorcontrib>Yonas, Howard</creatorcontrib><title>Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Purpose: The purpose of this study was to determine whether the hemodynamic consequences of extracranial carotid disease correlate with the risk of subsequent cerebral infarction.
Methods: In 95 patients with symptoms who had greater than or equal to 70% stenosis (31 patients) or who had occlusion (64 patients) of the ipsilateral carotid artery, cerebral blood flow was measured by the stable xenon/computed tomography technique both at baseline and after vasodilatory challenge with intravenous acetazolamide. Patients were stratified into group 1, 43 patients with no more than a 5% decrease in flow in any vascular territory, and group 2, 52 patients with greater than a 5% decrease in one or more vascular territories after an acetazolamide challenge.
Results: In group 2, 15 (28.9%) of 52 patients had a new stroke, but only one (2.3%) of 43 patients in group 1 did (
p = 0.0005). Of patients with total carotid occlusion 10 (26%) of 38 in group 2 and none (0%) of 26 in group 1 had a new stroke (
p = 0.003). Of patients with greater than or equal to 70% stenosis, five (36%) of 14 in group 2 and only one (6%) of 17 in group 1 had a stroke (
p = 0.067).
Conclusion: The loss of cerebral reactivity in patients with symptoms who had greater than or equal to 70% carotid stenosis or occlusion is an important predictor of impending cerebral infarction. (J V
ASC S
URG 1995;21:338-45.)</description><subject>Acetazolamide - pharmacology</subject><subject>Adult</subject><subject>Aged</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - diagnostic imaging</subject><subject>Carotid Stenosis - physiopathology</subject><subject>Cerebral Arteries - drug effects</subject><subject>Cerebral Arteries - physiopathology</subject><subject>Cerebral Infarction - diagnostic imaging</subject><subject>Cerebral Infarction - etiology</subject><subject>Cerebral Infarction - physiopathology</subject><subject>Cerebrovascular Circulation - drug effects</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Cerebrovascular Disorders - diagnostic imaging</subject><subject>Cerebrovascular Disorders - etiology</subject><subject>Cerebrovascular Disorders - physiopathology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Vasodilator Agents - pharmacology</subject><subject>Xenon</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9rGzEQxUVoSJ20H8Ewp9IeNpF2VyvpVIpp_kAgh6RnIUuzRO2utZVkGx_zzavYxteeBmbem8f7ETJn9JpR1t08U9Gyites_ar4N0Fr0VbsjMwYVaLqJFUfyOwk-UguU_pNKWNcigtyISRvOspn5G0RximG0Sd0YDHiMpoBlkMIDvohbCGisdlvfN6BT2Bgiui8zSFC6CHlGP4g-BVMJntc5QRbn18h7cYph7HsLFgTQ_YOTMwYdxCsHdbJbxBcyTQJP5Hz3gwJPx_nFfl1-_NlcV89Pt09LH48VralIlctl1TQzgrqZM8Vaw3njLPOSeqwV8Yq19m-MUtOpZKNUUXjuq6pRSO4rJvminw5_C11_64xZV1KWxwGs8KwTloI1hY-dRHyg9DGkFLEXk_RjybuNKP6Hb3eo9fvXLXieo9es-KbHwPWyxHdyXVkXe7fD3csLTceo062MLOFZ0SbtQv-Pwn_APNrlT0</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>Webster, Marshall W.</creator><creator>Makaroun, Michel S.</creator><creator>Steed, David L.</creator><creator>Smith, Holly A.</creator><creator>Johnson, David W.</creator><creator>Yonas, Howard</creator><general>Mosby, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950201</creationdate><title>Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease</title><author>Webster, Marshall W. ; Makaroun, Michel S. ; Steed, David L. ; Smith, Holly A. ; Johnson, David W. ; Yonas, Howard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-4580706c70d8f5914a551516d80def9ac9d6cf3ab508983a9591d663273758233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Acetazolamide - pharmacology</topic><topic>Adult</topic><topic>Aged</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - diagnostic imaging</topic><topic>Carotid Stenosis - physiopathology</topic><topic>Cerebral Arteries - drug effects</topic><topic>Cerebral Arteries - physiopathology</topic><topic>Cerebral Infarction - diagnostic imaging</topic><topic>Cerebral Infarction - etiology</topic><topic>Cerebral Infarction - physiopathology</topic><topic>Cerebrovascular Circulation - drug effects</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Cerebrovascular Disorders - diagnostic imaging</topic><topic>Cerebrovascular Disorders - etiology</topic><topic>Cerebrovascular Disorders - physiopathology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Vasodilator Agents - pharmacology</topic><topic>Xenon</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Webster, Marshall W.</creatorcontrib><creatorcontrib>Makaroun, Michel S.</creatorcontrib><creatorcontrib>Steed, David L.</creatorcontrib><creatorcontrib>Smith, Holly A.</creatorcontrib><creatorcontrib>Johnson, David W.</creatorcontrib><creatorcontrib>Yonas, Howard</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Webster, Marshall W.</au><au>Makaroun, Michel S.</au><au>Steed, David L.</au><au>Smith, Holly A.</au><au>Johnson, David W.</au><au>Yonas, Howard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>21</volume><issue>2</issue><spage>338</spage><epage>345</epage><pages>338-345</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>Purpose: The purpose of this study was to determine whether the hemodynamic consequences of extracranial carotid disease correlate with the risk of subsequent cerebral infarction.
Methods: In 95 patients with symptoms who had greater than or equal to 70% stenosis (31 patients) or who had occlusion (64 patients) of the ipsilateral carotid artery, cerebral blood flow was measured by the stable xenon/computed tomography technique both at baseline and after vasodilatory challenge with intravenous acetazolamide. Patients were stratified into group 1, 43 patients with no more than a 5% decrease in flow in any vascular territory, and group 2, 52 patients with greater than a 5% decrease in one or more vascular territories after an acetazolamide challenge.
Results: In group 2, 15 (28.9%) of 52 patients had a new stroke, but only one (2.3%) of 43 patients in group 1 did (
p = 0.0005). Of patients with total carotid occlusion 10 (26%) of 38 in group 2 and none (0%) of 26 in group 1 had a new stroke (
p = 0.003). Of patients with greater than or equal to 70% stenosis, five (36%) of 14 in group 2 and only one (6%) of 17 in group 1 had a stroke (
p = 0.067).
Conclusion: The loss of cerebral reactivity in patients with symptoms who had greater than or equal to 70% carotid stenosis or occlusion is an important predictor of impending cerebral infarction. (J V
ASC S
URG 1995;21:338-45.)</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>7853605</pmid><doi>10.1016/S0741-5214(95)70274-1</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of vascular surgery, 1995-02, Vol.21 (2), p.338-345 |
| issn | 0741-5214 1097-6809 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Acetazolamide - pharmacology Adult Aged Carotid Stenosis - complications Carotid Stenosis - diagnostic imaging Carotid Stenosis - physiopathology Cerebral Arteries - drug effects Cerebral Arteries - physiopathology Cerebral Infarction - diagnostic imaging Cerebral Infarction - etiology Cerebral Infarction - physiopathology Cerebrovascular Circulation - drug effects Cerebrovascular Circulation - physiology Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - etiology Cerebrovascular Disorders - physiopathology Disease-Free Survival Female Follow-Up Studies Forecasting Humans Male Middle Aged Recurrence Retrospective Studies Risk Factors Tomography, X-Ray Computed - methods Vasodilator Agents - pharmacology Xenon |
| title | Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease |
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