Extracranial Carotid Plaque Length and Parent Vessel Diameter Significantly Affect Baseline Ipsilateral Intracranial Blood Flow
Abstract BACKGROUND: The degree of carotid artery stenosis has traditionally been used as a marker of hemodynamic compromise and increased stroke risk. However, the hemodynamic effect of carotid atherosclerotic plaque length on cerebral blood flow has not previously been studied. OBJECTIVE: To deter...
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Veröffentlicht in: | Neurosurgery 2011-10, Vol.69 (4), p.767-773 |
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Sprache: | eng |
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Zusammenfassung: | Abstract
BACKGROUND:
The degree of carotid artery stenosis has traditionally been used as a marker of hemodynamic compromise and increased stroke risk. However, the hemodynamic effect of carotid atherosclerotic plaque length on cerebral blood flow has not previously been studied.
OBJECTIVE:
To determine whether carotid plaque length, in addition to degree of stenosis, significantly affects carotid blood flow in patients with >65% carotid stenosis.
METHODS:
Consecutively treated surgical patients with unilateral >65% carotid stenosis at a single institution were analyzed. Quantitative measurements of plaque length, internal carotid artery (ICA) vessel diameter, and degree of stenosis were made from magnetic resonance angiography images. Quantitative phase-contrast magnetic resonance angiography flow maps were generated to estimate ICA flow compromise by calculating a ratio of the ipsilateral/contralateral ICA flow rates.
RESULTS:
Of 38 eligible patients, 23 had full anatomic and ICA flow data sets available for analysis. Univariate regression analysis demonstrated that longer carotid plaques and increasing percentage carotid stenosis were associated with a significant decline in ipsilateral ICA flow (P = .008 and P = .02, respectively). A multivariate regression identified both plaque length and vessel diameter as independent predictors of ICA flow (P = .001 and P = .002, respectively).
CONCLUSION:
Carotid plaque length and vessel diameter appear to be significant variables, in addition to degree of stenosis, in predicting ipsilateral carotid blood flow compromise in patients undergoing carotid revascularization. |
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ISSN: | 0148-396X 1524-4040 |
DOI: | 10.1227/NEU.0b013e31821ff8f4 |