(Stroke. 1995;26:84-89.)
© 1995 American Heart Association, Inc.
Articles |
Hemodynamic Effects of Carotid Endarterectomy by Magnetic Resonance Flow Quantification
From the Departments of Clinical Radiology (R.V., H.M., K.P.), Neurology (K.K.), and Surgery (H.T.), Kuopio University Hospital, Kuopio, Finland.
Correspondence to Ritva Vanninen, MD, Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, SF-70210, Kuopio, Finland.
Background and Purpose Blood flow can be evaluated noninvasively using magnetic resonance phase-contrast flow quantification. The purpose of this prospective study was to assess the feasibility of this method and to evaluate the hemodynamic effects of carotid endarterectomy.
Methods Volumetric flow rates and peak systolic velocities of the internal and common carotid and the vertebral arteries were measured by magnetic resonance flow quantification. Sixteen patients undergoing 18 endarterectomies had complete flow data recorded preoperatively and 3 days after surgery.
Results The inverse correlation between the angiographic stenosis degree and the preoperative flow rate in the corresponding internal carotid artery was highly significant (r=-.69, P<.001). After endarterectomy, the mean flow in the ipsilateral internal carotid artery improved from 143 to 233 mL/min (P<.001). The mean peak systolic velocity increased from 23 to 37 cm/s (P<.001). No significant changes were seen in the contralateral carotid or the vertebral arteries. The mean total blood flow improved by 81 mL/min (P=.08). In the severely stenosed bifurcations (70% to 99%, n=11), the flow rate improved by 106 mL/min and in the moderately (30% to 69%, n=4) or mildly (<30%, n=3) stenosed bifurcations by 63 mL/min. If the contralateral carotid artery was occluded or severely stenosed, the improvement was 164 mL/min.
Conclusions Magnetic resonance flow quantification provides a useful tool for the follow-up of the hemodynamic effects of carotid endarterectomy. Our results indicate that surgery is followed by a significant increase of blood flow in the ipsilateral carotid artery and that there appear to be differences in flow increase between subgroups of patients with different degrees of stenosis.
Key Words: carotid arteries • carotid endarterectomy • hemodynamics • magnetic resonance imaging
This article has been cited by other articles:
 |
|
 |
|
  D J DINTER, K A BUESING, S J DIEHL, and K W NEFF Blood volume flow quantification of the brain-supplying circulation in fibromuscular dysplasia using 2D cine phase-contrast MRI Br. J. Radiol., June 1, 2009; 82(978): 459 - 467. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. Heyer, M. I. Gold, E. W. Kirby, J. Zurica, E. Mitchell, H. J. Halazun, L. Teverbaugh, R. R. Sciacca, R. A. Solomon, D. O. Quest, et al. A Study of Cognitive Dysfunction in Patients Having Carotid Endarterectomy Performed with Regional Anesthesia Anesth. Analg., August 1, 2008; 107(2): 636 - 642. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Adhiyaman and S. Alexander Cerebral hyperperfusion syndrome following carotid endarterectomy QJM, April 1, 2007; 100(4): 239 - 244. [Full Text] [PDF]
|
|
|
|
 |
|
 K. W. Neff, P. Horn, P. Schmiedek, C. Duber, and D. J. Dinter 2D cine phase-contrast MRI for volume flow evaluation of the brain-supplying circulation in moyamoya disease. Am. J. Roentgenol., July 1, 2006; 187(1): W107 - W115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kamouchi, K. Kishikawa, Y. Okada, T. Inoue, K. Toyoda, S. Ibayashi, and M. Iida Transoral Ultrasonographic Evaluation of Carotid Flow in Predicting Cerebral Hemodynamics after Carotid Endarterectomy AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1295 - 1299. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hendrikse, D. R. Rutgers, C. J.M. Klijn, B. C. Eikelboom, and J. van der Grond Effect of Carotid Endarterectomy on Primary Collateral Blood Flow in Patients With Severe Carotid Artery Lesions Stroke, July 1, 2003; 34(7): 1650 - 1654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Soinne, J. Helenius, T. Tatlisumak, E. Saimanen, O. Salonen, P. J. Lindsberg, and M. Kaste Cerebral Hemodynamics in Asymptomatic and Symptomatic Patients With High-Grade Carotid Stenosis Undergoing Carotid Endarterectomy Stroke, July 1, 2003; 34(7): 1655 - 1661. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K J van Everdingen, L J Kappelle, C J M Klijn, W P T M Mali, and J van der Grond Clinical features associated with internal carotid artery occlusion do not correlate with MRA cerebropetal flow measurements J. Neurol. Neurosurg. Psychiatry, March 1, 2001; 70(3): 333 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Rutgers, J. D. Blankensteijn, and J. van der Grond Preoperative MRA Flow Quantification in CEA Patients : Flow Differences Between Patients Who Develop Cerebral Ischemia and Patients Who Do Not Develop Cerebral Ischemia During Cross-Clamping of the Carotid Artery Stroke, December 1, 2000; 31(12): 3021 - 3028. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Kappelle, M. Eliasziw, A. J. Fox, B. L. Sharpe, and H. J. M. Barnett Importance of Intracranial Atherosclerotic Disease in Patients With Symptomatic Stenosis of the Internal Carotid Artery Stroke, February 1, 1999; 30(2): 282 - 286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kluytmans, J. van der Grond, B. C. Eikelboom, and M. A. Viergever Long-Term Hemodynamic Effects of Carotid Endarterectomy Stroke, August 1, 1998; 29(8): 1567 - 1572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Heyer, D. C. Adams, R. A. Solomon, G. J. Todd, D. O. Quest, D. J. McMahon, S. D. Steneck, T. F. Choudhri, and E. S. Connolly Neuropsychometric Changes in Patients After Carotid Endarterectomy Stroke, June 1, 1998; 29(6): 1110 - 1115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. van Everdingen, C. J. M. Klijn, L. J. Kappelle, W. P. T. M. Mali, and J. van der Grond MRA Flow Quantification in Patients With a Symptomatic Internal Carotid Artery Occlusion Stroke, August 1, 1997; 28(8): 1595 - 1600. [Abstract] [Full Text]
|
|
|
|
|
|
J. van der Grond, B.C. Eikelboom, and W.P.Th.M. Mali Flow-Related Anaerobic Metabolic Changes in Patients With Severe Stenosis of the Internal Carotid Artery Stroke, November 1, 1996; 27(11): 2026 - 2032. [Abstract] [Full Text]
|
|