Comparison of Asymmetry in Cerebral Blood Flow Between Brain Hemispheres Using Digital Subtraction Angiography

Divani, Afshin A.; Qureshi, Adnan I.; Hoffman, Kenneth R.; Suri, M. Fareed K.; Kirmani, Jawad F.

doi:10.1111/j.1552-6569.2006.00024.x

Cited by 14 publications

(14 citation statements)

References 10 publications

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“…5,9,14,24,32,33) In many cases, the observer subjectively determines the angiographic circulation time visually, resulting in inter-observer variance. 9,14,32,33) To obtain objective measurements in this study, the CCT was determined based on time-density curves generated from a ROI in the terminal portion of the ICA and a ROI in the cortical vein draining the territory of the MCA.…”

Section: Discussionmentioning

confidence: 99%

Intraprocedural Changes in Angiographic Cerebral Circulation Time Predict Cerebral Blood Flow After Carotid Artery Stenting

Aikawa

Kaneda

Tsutsumi

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Changes in the cerebral blood flow (CBF) are important for planning postoperative care in patients treated by carotid artery stenting (CAS). The relationship between intraprocedural changes in the angiographic cerebral circulation time (CCT) and perioperative CBF changes were retrospectively studied in 49 CAS procedures performed in 46 patients with carotid artery stenosis. The CCT, defined as the interval between the timing of maximal opacification at the terminal portion of the internal carotid artery and at the cortical vein, was determined by referring to time-density curves of data obtained from routine intraprocedural digital subtraction angiography. The intraoperative change in CCT (DCCT) was calculated for each of the 49 procedures. CBF studies, using dynamic perfusion computed tomography, were performed 10-2 days before and 2-4 days after CAS. Perioperative changes in the ratio of the CBF in the territory of the middle cerebral artery on the affected side to CBF on the contralateral side (%CBF) were calculated by subtracting pre-from postoperative %CBF (D%CBF) and the correlation between DCCT and D%CBF was evaluated. Mean CCT was shortened by 1.1 seconds from 5.3 to 4.2 seconds after CAS. Mean %CBF increased by 11.9% from 91.8% to 103.7% after the procedure. DCCT and D%CBF showed a significant positive correlation (r ＝ 0.61, p ＝ 0.008). Intraprocedural changes in angiographic CCT are predictive of postoperative CBF in patients with CAS.

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Section: Discussionmentioning

confidence: 99%

Intraprocedural Changes in Angiographic Cerebral Circulation Time Predict Cerebral Blood Flow After Carotid Artery Stenting

Aikawa

Kaneda

Tsutsumi

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…A 6-French guide catheter was placed in the arch of aorta and contrast was injected using a programmed infusion system [15]. Concomitant cranial images are acquired in the Townes projection (anteroposterior axis) in rapid frames.…”

Section: Endovascular Treatment Protocolmentioning

confidence: 99%

Subacute Recanalization and Reocclusion in Patients with Acute Ischemic Stroke Following Endovascular Treatment

Qureshi

Hussein

Abdelmoula³

et al. 2008

Neurocrit Care

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“…The image processing procedure to calculate time-density curves has been described elsewhere. 7 Briefly, image analysis was performed using a graphical user interface program written in MATLAB (V6.0, MathWorks, Inc., Natick, MA). A region-of-interest (ROI) was defined on the left brain hemisphere to calculate the average contrast density in the ipsilateral brain parenchyma for each image in the sequence.…”

Section: A Clinical Case Of Eca Occlusionmentioning

confidence: 99%

Augmenting Regional Cerebral Blood Flow Using External-to-Internal Carotid Artery Flow Diversion Method

Divani

Berezina²,

Vázquez

et al. 2009

Ann Biomed Eng

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The objective of this study was to assess the effect of flow diversion by external carotid artery (ECA) occlusion on ipsilateral regional cerebral blood flow (rCBF). Local cerebral hyperperfusion in rats (n = 12) was induced by ligating the right ECA. Ipsilateral rCBF was determined pre- and post-ligation for 120 min using a laser Doppler flow meter. Sham animals (n = 6) were subjected to the craniotomy without ligation of the right ECA. In a separate series of rats (n = 5), brain tissue oxygen levels (pO(2)) in the right and left brain hemispheres were determined before and 90 min after ligation of the right ECA using a tissue oxygenation monitoring unit. We investigated the effect of ECA occlusion hemispheric changes in rCBF in one clinical case as a proof of concept. Ligation of ECA resulted in a statistically significant increase in rCBF on the ipsilateral side compared to the sham-operated rats (p < 0.0001). On average we observed a 34% increase (95% CI: 24-45%) in rCBF in the ipsilateral territory in the treated group compared with sham-operated rats. There was no significant variation in MAP for the treated animals. Vascular permeability and cerebral water content in the right hemisphere after ligation of ECA did not significantly differ from the contralateral hemisphere. Ipsilateral hemisphere tissue pO(2) was significantly higher compared to the contralateral area (p < 0.002) post-ligation or to the ipsilateral area (p < 0.001) prior to ligation. In the clinical case, occlusion of ECA resulted in 3.6% and 12.1% increase in peak value and rise-time of the time-density curves. Flow diversion by temporary occlusion of the ECA can result in increased rCBF and cerebral pO(2) on the ipsilateral side. The strategy may represent a viable option to augment rCBF in focal cerebral ischemia.

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Comparison of Asymmetry in Cerebral Blood Flow Between Brain Hemispheres Using Digital Subtraction Angiography

Cited by 14 publications

References 10 publications

Intraprocedural Changes in Angiographic Cerebral Circulation Time Predict Cerebral Blood Flow After Carotid Artery Stenting

Intraprocedural Changes in Angiographic Cerebral Circulation Time Predict Cerebral Blood Flow After Carotid Artery Stenting

Subacute Recanalization and Reocclusion in Patients with Acute Ischemic Stroke Following Endovascular Treatment

Augmenting Regional Cerebral Blood Flow Using External-to-Internal Carotid Artery Flow Diversion Method

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