Evaluation of Changes in the Parameters of Brain Tissue Perfusion in Multi-slice Computed Tomography in Patients After Carotid Artery Stenting

Overview

Journal Pol J Radiol

Publisher Termedia

Specialty Radiology

Date 2012 Jul 18

PMID 22802836

Citations 7

Authors

Arkadiusz Szarmach

Grzegorz Halena

Jacek Buczny

Michal Studniarek

Karolina Markiet

Edyta Szurowska

Mariusz Retkowski

Maciej Piskunowicz

Affiliations

Soon will be listed here.

Abstract

Background: CT perfusion of the brain allows functional evaluation of cerebral blood flow. Patients with chronic internal carotid artery (ICA) stenosis may suffer from malperfusion. Improvement of cerebral blood flow and remission of neurological symptoms indicate the effectiveness of treatment of internal carotid artery stenosis.

Material/methods: The aim of the study was to analyze alterations within cerebral perfusion parameters in CT brain perfusion examination in patients who were scheduled for endovascular therapy due to ICA stenosis. Forty patients with ICA stenosis of over 79% who were included in this prospective study underwent perfusion CT examination twice - 24 hours prior to stenting and after 6-8 weeks following the procedure. CBF, CBV, MTT and TTP were evaluated.

Results: Prior to endovascular therapy, an increase in MTT and TTP, and a decrease in CBV and CBF were observed within arterial supply of the hemisphere ipsilateral to stenosis. After the procedure, a decrease in MTT and TTP was seen in all cases, while no statistically significant changes of CBF or CBV were observed. MTT proved to be the most sensitive indicator of ICA stenosis, as its values allowed differentiation between critical and non-critical stenosis. No correlation between the degree of ICA stenosis and TTP values was found. Mild cerebral hyperperfusion syndrome (CHS) was observed in only one patient and the difference between pre-treatment MTT values calculated for both hemispheres was shown to be a prognostic factor for CHS incidence.

Conclusions: Endovascular stent placing in patients with hemodynamically significant internal carotid artery stenosis results in alteration of perfusion parameters, especially concerning TTP and MTT.

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Multiple blood flow measurements before and after carotid artery stenting via phase-contrast magnetic resonance imaging: An observational study.

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Lin C, Su J, Chang Y, Liu C, Lu H, Jong Y Medicine (Baltimore). 2017; 96(12):e6363.

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