Evolution of the Flow Patterns After Endovascular Treatment in Patients with High-Grade Carotid Artery Stenosis - the Clinical Value of Insonation of the Supratrochlear Artery and Alternating Flow |
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| Institution: | 1. Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai district, Beijing 100070, China;2. Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing 100070, China;3. The George Institute for Global Health at Peking University Health Science Center, Beijing, China;4. Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia;5. Department of Ultrasound, Huaian Hospital of Huaian City, Huaian, Jiangsu, China;1. Stroke Unit. Department of Neurology. Hospital UniversitarI Doctor Josep Trueta de Girona. Girona Biomedical Research Institute (IDIBGI). Girona, Spain;2. Statistical and Methodological Advisory Unit, Girona Biomedical Research Institute (IDIBGI), Girona, Spain;3. Cerebrovascular Pathology Research Group, Department of Neurology, Girona Biomedical Research Institute (IDIBGI), Girona, Spain;1. Department of Radiology, Mayo Clinic;2. Department of Quantitative Health Sciences, Mayo Clinic;3. Department of Neurology, Mayo Clinic;4. Department of Quantitative Health Sciences, Mayo Clinic;1. Department of Neurosurgery, Iwate Medical University, Japan;2. Institute for Biomedical Sciences, Iwate Medical University, Japan;1. Department of Neurology, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA;2. Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA;3. Division of Neurocritical Care, Department of Neurology and Neurological Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd. #8897, Dallas, TX 75390-8897, USA;1. Department of Rehabilitation Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan;2. Faculty of Medical Science, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806, Japan;3. Department of Rehabilitation Medicine, Sakuragaoka Central Hospital, 1-7-1 Fukuda, Yamato, Kanagawa 242-0024, Japan;4. Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan |
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| Abstract: | AimWe aimed to describe the evolution of flow pattern in the ophthalmic artery (OA) and supratrochlear artery (SA) by transcranial Doppler (TCD) ipsilateral to a severe proximal carotid artery stenosis before and after staged endovascular treatment (EVT).MethodsWe insonated and recorded the flow patterns of OA and SA in 63 patients with ≥ 80% carotid artery stenosis before and after staged carotid angioplasty and stenting at 2-4 weeks apart. Based on the direction of OA and SA blood flow, we categorized patients into (1) reversed, (2) alternating, or (3) forward flow, groups. We evaluated the evolving sonographic flow patterns in OA and SA at the 3-time points and correlated them with the stenotic and flow velocity change.ResultsDespite the disconcordance between OA and SA, the evolution of flow direction were evoluted from reversed to alternating or from alternating to forward in both OA and SA. OA and SA's disagreement rate at three-time points was 19.1%, 49.2%, and 28.6%, respectively. After angioplasty alone, we detected an alternating flow in 21 (33.3%) and 46 (73.0%) patients in OA and SA, respectively. Alternating flow patterns in SA persisted in 20 patients (31.7%) after stenting. The post-angioplasty residual stenosis did not differ between the three flow pattern groups (p>0.05).ConclusionsAn alternating flow in OA or SA might mark the hemodynamic recovery after EVT. Insonation of SA may provide supporting evidence for hemodynamic change in patients with carotid artery stenosis undergoing EVT. |
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