Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis.

Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis. Research Abstract Details 

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Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis. Abstract Text:

Akihiko Hino,Hiroshi Tenjin,Yoshiharu Horikawa,Masahito Fujimoto,Yoshio Imahori,

In symptomatic stenosis of the internal carotid artery (ICA), the predominant mechanism of ischemic event is considered thromboembolic. Carotid endarterectomy (CEA) removes the embolic source and is accepted as the major benefit from the surgery. Even in high-degree stenosis, hemodynamic compromise as a causal factor for cerebral ischemia remains controversial, however. We used positron emission tomography (PET) to evaluate possible hemodynamic and/or metabolic changes caused by a severe ICA stenosis and the subsequent changes after CEA. Subjects consisted of 10 patients with recent transient ischemic attack and/or minor stroke whose carotid stenosis exceeded 80% (mean, 92%). We measured regional cerebral blood flow (CBF), oxygen extraction fraction (OEF), oxygen metabolic rate (CMRO(2)), and regional cerebral blood volume (CBV) before and after the CEA. In addition, we calculated CBF/CBV value as an indicator of tissue perfusion reserve. We compared these PET values to those of 15 age-matched normal controls. Significant reductions in CBF, CBF/CBV, and CMRO(2) values were observed in the hemisphere not only ipsilateral, but also contralateral to the stenosis. In 4 patients, an increase in OEF and decrease in CBF/CBV were also detected. These variables significantly recovered after CEA. High-degree carotid stenosis in the tested range reduces cerebral hemodynamic and metabolic reserve and forms a vulnerable environment in the brain. Successful CEA benefits not only by removing embolic source, but also by improving hemodynamic status, which may be seen in even the contralateral hemisphere.

Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis. Publishing Authors By Initials

A Hino,H Tenjin,Y Horikawa,M Fujimoto,Y Imahori,

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Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of stroke and cerebrovascular diseases : t

VOLUME: 14

Page Numbers: 234-8

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ISSN: 1532-8511

DAY: 1

MONTH: 10

YEAR: 2007

Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis. Information

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LANGUAGE: eng

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Grant and Affiliation Information for Hemodynamic and metabolic changes after carotid endarterectomy in patients with high-degree carotid artery stenosis.

AFFILIATION: Department of Neurosurgery, Saiseikai Shigaken Hospital, Shiga, Japan.

Country: United States

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MEDLINETA: J Stroke Cerebrovasc Dis

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