Collateral compensation of severe carotid stenosis

Gee, William; Lucke, Joseph F.; Madden, Alice E.

doi:10.1016/s0950-821x(89)80064-7

Cited by 9 publications

(1 citation statement)

References 4 publications

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“…Another consideration is the fact that a severe stenosis in the cervical carotid may not affect hemodynamics intracranially because of pressure-flow equilibration by the circle of Willis and other collaterals [37]. OPG [38] and transcranial Doppler [39] with vasomotor reactivity (VMR) testing are inexpensive methods for obtaining this important information. Ricotta and coworkers [40] investigated the hemodynamics of carotid lesions intraoperatively and determined that lesions producing more than a 60% diameter reduction when measured by MRL/DL uniformly represent hemodynamically significant lesions as determined by pressure gradient.…”

Section: Sinusmentioning

confidence: 99%

Accurate Measurement of Carotid Stenosis

Toole

Castaldo

1994

Journal of Neuroimaging

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The methods used for measurement of carotid artery stenosis are not uniform. Witness the chaos that developed when the North American Symptomatic Carotid Endarterectomy Trial (NASCET) group changed its classification system from area to linear measurements only to discover that the European Carotid Stenosis Trial (ECST) used still another angiographic definition of degree of stenosis so that the data from the two studies were not comparable. Fortunately, this has been reconciled by recalculation of the data. In still other studies, using unvalidated ultrasound instruments has made it difficult or impossible to compare results. In part, these problems have been the result of misdirected attempts to amalgamate concepts from Doppler and duplex ultrasound with those of arteriography. The former is more precise and accurate than the latter, yet its methodology is harder to apply and has not been generally distributed. Even such anatomical terms as "carotid bulb" are not standard. Ultrasonographers consider it to be the distal common carotid artery, to vascular surgeons it is the carotid sinus, while still others consider it to be both or neither. The present authors advocate a uniform methodology utilizing duplex ultrasound and predict that it plus magnetic resonance angiography will become the standard by which extracranial carotid artery disease is evaluated in the future.

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Section: Sinusmentioning

confidence: 99%