Effect of Carotid Artery Stenting on Ophthalmic Artery Flow Patterns

Altınbaş, Namık Kemal; Üstüner, Evren; Özcan, Hasan; Bilgiç, Sadık; Sancak, Tanzer; Düşünceli, Ebru

doi:10.7863/ultra.33.4.629

Cited by 10 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ophthalmic artery blood flow (and not the upstream carotid artery blood flow) before CEA will determine the improvement in ocular perfusion after CEA. If there is a decrease in ophthalmic artery blood flow due to ICA stenosis, it will improve after CEA [5–7] and will result in an increase in choroidal thickness. If there is no decrease in ophthalmic artery blood flow, there will be no change in choroidal thickness after CEA.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that a 90% carotid stenosis can reduce the ipsilateral central retinal artery perfusion pressure by approximately 50% [1–4] and as the degree of internal carotid artery (ICA) stenosis increases, the flow in ophthalmic artery decreases. In severe stenosis, the flow is not detectable or a reversed flow may be present [5–7]. Amaurosis fugax (AF), central retinal artery occlusion, and ocular ischemic syndrome (OIS) are among the problems of carotid disease and may eventually lead to permanent blindness [1, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up

Rabina

Barequet

Rabinovitch

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To evaluate the change in choroidal thickness after carotid artery endarterectomy (CEA) in patients without retinal pathology. Methods A prospective series of patients who underwent CEA at the Tel Aviv Medical Center. Spectral domain optical coherence tomography (SD-OCT) was performed one day before the CEA and at least 6 months after. Data included medical history, smoking history, percentage of carotid stenosis before and after CEA, best-corrected visual acuity (BCVA), central macular thickness (CMT), and choroidal thickness (subfoveal, 500 µm, 1000 µm, and 1500 µm nasal and temporal). Results Eight patients (seven male and one female) with a mean age of 70.5 ± 6.1 years were included in the study. The mean internal carotid artery (ICA) stenosis was 89.8% ± 5.1 in the operated side, 33.7% ± 10.9 in the nonoperated side (p < 0.0001), and 0% after CEA (p < 0.0001). Operated side BCVA was 0.35 ± 0.66 compared to 0.61 ± 0.83 in the nonoperated side (p=0.51). The mean subfoveal choroidal thickness (SFChT) of the operated side was 277 ± 67 µm compared to 268 ± 71 µm in the nonoperated side (p=0.81). SFChT and CMT after CEA were 275 ± 64 µm (p=0.96) and 268 ± 29 µm (p=0.98), respectively. Conclusions SFChT and CMT in patients without retinal or choroidal pathology and significant ICA stenosis can be normal and may not change after successful ipsilateral CEA.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up

Rabina

Barequet

Rabinovitch

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…[ 6 , 7 ] In addition, a report indicated that carotid artery stenting in a patient with severe ICA stenosis shifts the blood flow pattern of the ophthalmic artery from retrograde to antegrade, suggesting that retrograde collateral circulation is developed. [ 8 ] In our case, a soft, padded, rectangular headrest filled with gel that included space (diameter 12 cm) to rest the forehead and chin was used to provide direct compression-free positioning for the eyes; therefore, direct compression of the eye was relatively unlikely to be involved in central retinal artery occlusion. Thus, compromised collateral circulation from the left ECA, which feeds the ophthalmic artery, was highly likely to contribute to central retinal artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

Visual loss due to optic nerve infarction and central retinal artery occlusion after spine surgery in the prone position

et al. 2017

View full text Add to dashboard Cite

Rationale:Visual loss after spine surgery in the prone position is a serious complication. Several cases of central retinal artery occlusion with ophthalmoplegia after spine surgery have been reported in patients with ophthalmic arteries fed by the internal carotid artery (ICA) in a normal manner.Patient concerns:A 74-year-old man developed visual loss after undergoing a spinal decompression and fusion operation in the prone position that lasted approximately 5 hours.Diagnoses:We detected an extremely rare case of visual loss due to optic nerve infarction and central retinal artery occlusion through fundoscopic examination, fluorescein angiogram, brain magnetic resonance imaging, and magnetic resonance angiography. The patient's visual loss may have been caused by compromised retrograde collateral circulation of the ophthalmic artery from branches of the external carotid artery in the presence of proximal ICA occlusion after a spinal operation in the prone position.Interventions:To recover movement of the left extraocular muscles, the patient received intravenous injections of methylprednisolone for 3 days and then oral prednisolone for 6 days.Outcomes:Twenty days after the treatment, the motion of the left extraocular muscles was significantly improved. However, recovery from the left visual loss did not occur until 4 months after the operation.Lessons:In high-risk patients with retrograde collateral circulation of the ophthalmic artery from the external carotid artery due to proximal ICA occlusion, various measures, including the use of a head fixator to provide a position completely free of direct compression of the head and face, should be considered to decrease the risk of postoperative visual loss.

show abstract

“…Moreover, the detection of reversed OA flow direction by CDI has shown high specificity for severe ipsilateral ICA stenosis or occlusion [106]. Reduced OA flow parameters in patients with severe carotid artery disease significantly improved after carotid stenting [107,108]. Similarly, chronic ocular ischemic syndrome resulting from severe carotid artery stenosis improved after carotid artery stenting, with significant increases in antegrade OA blood flow and PSV observed within 24 h after the intervention [109] and during long-term follow-up [110].…”

Section: Clinical and Scientific Relevance Of CDI For Ocular And Card...mentioning

confidence: 99%

Measurement of Retrobulbar Blood Flow and Vascular Reactivity—Relevance for Ocular and Cardiovascular Diseases

Böhm,

Grauhan,

Pfeiffer

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Abnormal retrobulbar hemodynamics have been linked to the development of various ocular diseases, including glaucoma, age-related macular degeneration, and diabetic retinopathy. Additionally, altered retrobulbar blood flow has been observed in patients with severe cardiovascular diseases, including carotid artery occlusion, stroke, heart failure, and acute coronary syndrome. Due to the complex and intricate anatomy of retrobulbar blood vessels and their location behind the eyeball, measurement of retrobulbar blood flow and vascular reactivity, as well as the interpretation of the findings, are challenging. Various methods, such as color Doppler imaging, computed tomography angiography or magnetic resonance imaging, have been employed to assess retrobulbar blood flow velocities in vivo. Color Doppler imaging represents a fast and non-invasive method to measure retrobulbar blood flow velocities in vivo. While no information about vessel diameter can be gained performing this method, computed tomography angiography and magnetic resonance imaging provide information about vessel diameter and detailed information on the anatomical course. Additionally, ex vivo studies, such as myography, utilizing genetically modified animal models may provide high optical resolution for functional vascular investigations in these small vessels. To our best knowledge, this is the first review, presenting a detailed overview of methods aiming to evaluate retrobulbar blood flow and vascular reactivity in both humans and laboratory animals. Furthermore, we will summarize the disturbances observed in retrobulbar blood flow in retinal, optic nerve, and cardiovascular diseases.

show abstract

Effect of Carotid Artery Stenting on Ophthalmic Artery Flow Patterns

Cited by 10 publications

References 32 publications

Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up

Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up

Visual loss due to optic nerve infarction and central retinal artery occlusion after spine surgery in the prone position

Measurement of Retrobulbar Blood Flow and Vascular Reactivity—Relevance for Ocular and Cardiovascular Diseases

Contact Info

Product

Resources

About