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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| container_title | Neurosurgery |
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| creator | Douglas, Andrea F Christopher, Susan Amankulor, Nduka Din, Ryan Poullis, Mike Amin-Hanjani, Sepideh Ghogawala, Zoher |
| description | 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. |
| doi_str_mv | 10.1227/NEU.0b013e31821ff8f4 |
| format | Article |
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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.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/NEU.0b013e31821ff8f4</identifier><identifier>PMID: 21508878</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Oxford University Press</publisher><subject>Aged ; Biological and medical sciences ; Brain - blood supply ; Carotid arteries ; Carotid Stenosis - complications ; Carotid Stenosis - pathology ; Cerebrovascular Circulation - physiology ; Functional Laterality ; Humans ; Magnetic Resonance Angiography ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Neurosurgery ; Stents ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Neurosurgery, 2011-10, Vol.69 (4), p.767-773</ispartof><rights>Copyright © 2011 by the Congress of Neurological Surgeons</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-6a391674740ff48648e31b6c6ebbf34aef126a16d6ed8c89af8311cf0437d4563</citedby><cites>FETCH-LOGICAL-c470t-6a391674740ff48648e31b6c6ebbf34aef126a16d6ed8c89af8311cf0437d4563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24549775$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21508878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Douglas, Andrea F</creatorcontrib><creatorcontrib>Christopher, Susan</creatorcontrib><creatorcontrib>Amankulor, Nduka</creatorcontrib><creatorcontrib>Din, Ryan</creatorcontrib><creatorcontrib>Poullis, Mike</creatorcontrib><creatorcontrib>Amin-Hanjani, Sepideh</creatorcontrib><creatorcontrib>Ghogawala, Zoher</creatorcontrib><title>Extracranial Carotid Plaque Length and Parent Vessel Diameter Significantly Affect Baseline Ipsilateral Intracranial Blood Flow</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>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.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brain - blood supply</subject><subject>Carotid arteries</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - pathology</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Functional Laterality</subject><subject>Humans</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Stents</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqN0VFrFDEQB_AgFntWv4FIQMSnbZPNbJJ9bM-rHhwqaMW3ZTab1JRc9kx20T751Y3cVaVPPgXCb2Yy-RPyjLNTXtfq7N3q6pT1jAsruK65c9rBA7LgTQ0VMGAPyYJx0JVo5Zdj8jjnG8a4BKUfkeOaN0xrpRfk5-rHlNAkjB4DXWIaJz_QDwG_zZZubLyevlKM5QaTjRP9bHO2gb72uLWTTfSjv47eeYNxCrf03DlrJnqBxfho6XqXfcDiSut1_GfORRjHgV6G8fsTcuQwZPv0cJ6Qq8vVp-XbavP-zXp5vqkMKDZVEkXLpQIFzDnQEnTZupdG2r53AtA6XkvkcpB20Ea36LTg3DgGQg3QSHFCXu377tJYVstTt_XZ2BAw2nHOndZaAOfQFvninrwZ5xTL47paNFJrxmtRFOyVSWPOybpul_wW023HWfc7n67k093Pp5Q9PzSf-60d_hTdBVLAywPAbDC48mHG578OGmiVaoo727tx3v3f6F-rFKki</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Douglas, Andrea F</creator><creator>Christopher, Susan</creator><creator>Amankulor, Nduka</creator><creator>Din, Ryan</creator><creator>Poullis, Mike</creator><creator>Amin-Hanjani, Sepideh</creator><creator>Ghogawala, Zoher</creator><general>Oxford University Press</general><general>Lippincott Williams & Wilkins</general><general>Wolters Kluwer Health, Inc</general><scope>IQODW</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20111001</creationdate><title>Extracranial Carotid Plaque Length and Parent Vessel Diameter Significantly Affect Baseline Ipsilateral Intracranial Blood Flow</title><author>Douglas, Andrea F ; Christopher, Susan ; Amankulor, Nduka ; Din, Ryan ; Poullis, Mike ; Amin-Hanjani, Sepideh ; Ghogawala, Zoher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-6a391674740ff48648e31b6c6ebbf34aef126a16d6ed8c89af8311cf0437d4563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brain - blood supply</topic><topic>Carotid arteries</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - pathology</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Functional Laterality</topic><topic>Humans</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Stents</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Douglas, Andrea F</creatorcontrib><creatorcontrib>Christopher, Susan</creatorcontrib><creatorcontrib>Amankulor, Nduka</creatorcontrib><creatorcontrib>Din, Ryan</creatorcontrib><creatorcontrib>Poullis, Mike</creatorcontrib><creatorcontrib>Amin-Hanjani, Sepideh</creatorcontrib><creatorcontrib>Ghogawala, Zoher</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Douglas, Andrea F</au><au>Christopher, Susan</au><au>Amankulor, Nduka</au><au>Din, Ryan</au><au>Poullis, Mike</au><au>Amin-Hanjani, Sepideh</au><au>Ghogawala, Zoher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracranial Carotid Plaque Length and Parent Vessel Diameter Significantly Affect Baseline Ipsilateral Intracranial Blood Flow</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>69</volume><issue>4</issue><spage>767</spage><epage>773</epage><pages>767-773</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>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.</abstract><cop>Hagerstown, MD</cop><pub>Oxford University Press</pub><pmid>21508878</pmid><doi>10.1227/NEU.0b013e31821ff8f4</doi><tpages>7</tpages></addata></record> |
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| ispartof | Neurosurgery, 2011-10, Vol.69 (4), p.767-773 |
| issn | 0148-396X 1524-4040 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aged Biological and medical sciences Brain - blood supply Carotid arteries Carotid Stenosis - complications Carotid Stenosis - pathology Cerebrovascular Circulation - physiology Functional Laterality Humans Magnetic Resonance Angiography Male Medical imaging Medical sciences Middle Aged Neurosurgery Stents Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Extracranial Carotid Plaque Length and Parent Vessel Diameter Significantly Affect Baseline Ipsilateral Intracranial Blood Flow |
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