Correlation of Cerebrovascular Reserve as Measured by Acetazolamide-Challenged Perfusion CT with Collateral Circulation in Unilateral High Grade Carotid Stenosis

Hong, Doran; Lee, Young Hen; Seo, Hyung Suk; Je, Bo-Kyung; Suh, Sangil; Seol, Hae Young; Lee, Nam Joon; Kim, Jung Hyuk; Yang, Kyung-Sook

doi:10.3348/jksr.2014.70.1.1

Cited by 2 publications

(3 citation statements)

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“…Association of incomplete CoW finding on nEMRA and low cerebrovascular reserve has been documented as well [14]. nCEMRA that was used in our research, represents functional morphology of CoW as it displays only blood flow within the vessels [2].…”

Section: Discusionmentioning

confidence: 61%

“…For asymptomatic patients with ICA stenosis there is a lack of data from controlled prospective studies [19]. Retrospective post-hoc analyzes of a SMART group showed increased but not statistically significant risk of stroke in patients with "incomplete" CoW [14].…”

Section: Discusionmentioning

confidence: 99%

“…Improvement of cognitive function after carotid endarterectomy along with the improvement of cerebrovascular reactivity is emphasized [26]. Previously mentioned SMART study group was one of the rare studies that followed operated and non-operated asymptomatic patients with complete and incomplete CoW , still it was the retrospective study [14].…”

Section: Discusionmentioning

confidence: 99%

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Incomplete circle of Willis and cerebrovascular reactivity in asymptomatic patients before and after carotid endarterectomy

et al. 2021

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Introduction/Objective. Circle of Willis (CoW) provides the most significant collateral flow in the presence of significant stenosis or occlusion of internal carotid artery. In terms of collateral flow ?incomplete? type and ?complete? type of CoW can be recognized. Patients with carotid artery disease with incomplete CoW have lower cerebrovascular reactivity and higher risk for stroke. Cerebrovascular reactivity refers to the residual capacity of dilatation of cerebral blood vessels in the condition of insufficient blood flow. In this study we analyzed changes in cerebrovascular reactivity after carotid endarterectomy in asymptomatic patients with respect to complete and incomplete CoW morphology. Methods. In this study in 97 patients with asymptomatic carotid artery disease we measured cerebrovascular reactivity before and after carotid endarterectomy by using method of ?apnea test? and ? Breath Hold Index? (BHI). Patients were divided into two following groups: patients with ?complete? CoW and ?incomplete? CoW based on non-contrast magnetic resonance angio performed previously to the operation. Descriptive statistics, univariate analysis, and ANOVA for comparison of BHI values between groups were used. Results. Results showed significant increase in cerebrovascular reactivity at the side of stenosis in both groups of patients with complete CoW (BHI value increased from 0,897 to 1.090; F(1.65) = 30.788, p < 0.0005, parc. ?2 = 0.321) and incomplete CoW (BHI value increased from 0.690 to 1.010; F ( 1.27 ) = 62.318 , p < 0.0005, parc. ?2 = 0.698) and the more significant increase in the group of incomplete CoW compared to the group with complete CoW (F (1.92 ) = 4.557 , p =0.035 , parc. ?2 =0.047) Conclusion. In most asymptomatic patients, cerebrovascular reactivity restores to normal following carotid endarterectomy. Parameters of cerebrovascular reactivity are lower in patients with incomplete CoW and the increase after carotid endarterectomy is more significant in such patients.

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Section: Discusionmentioning

confidence: 61%

Section: Discusionmentioning

confidence: 99%