Cerebral hemodynamics and baroreflex sensitivity after carotid artery stenting
Article first published online: 23 MAY 2012
© 2012 John Wiley & Sons A/S
Acta Neurologica Scandinavica
Volume 127, Issue 1, pages 46–52, January 2013
How to Cite
Hsu L-C, Chang F-C, Kuo TBJ, Wong WJ, Hu H-H. Cerebral hemodynamics and baroreflex sensitivity after carotid artery stenting. Acta Neurol Scand: 2013: 127: 46–52. © 2012 John Wiley & Sons A/S.
- Issue published online: 8 DEC 2012
- Article first published online: 23 MAY 2012
- Manuscript Accepted: 11 APR 2012
- National Science Council Republic of China. Grant Number: NSC-89-2314-B-075-030
- baroreflex sensitivity;
- carotid stenosis;
- transcranial Doppler
The long-term hemodynamic effects of carotid angioplasty and stenting (CAS) are unclear. We performed a longitudinal study to investigate the variations in cerebral hemodynamics in patients undergoing CAS.
Materials and methods
We performed prospective evaluation of 63 symptomatic male patients (19 patients had transient ischemic attack and 44 had minor stroke; mean age: 77.3 ± 6.3 years [range: 51–86]). The mean blood flow velocities (MBFV) and pulsatility index (PI) of the middle cerebral arteries (MCA) on both sides were evaluated using transcranial color-coded Doppler (TCCD) ultrasonography. Cardiac autonomic activities were evaluated by measuring baroreflex sensitivity (BRS). All parameters were measured at baseline prior to CAS and at 1, 3, 6, and 12 months after CAS.
The preoperative MBFV and PI of the ipsilateral MCA were significantly lower than those of the contralateral side. However, after CAS, MBFV in the ipsilateral MCA increased significantly until 2 weeks after stenting, after which the MBFV gradually decreased and remained stable for 1 year after CAS. Further, we observed a nonsignificant increase in MBFV in the contralateral MCA after CAS. In contrast to the MBFV, the BRS values decreased significantly 1 month after stenting and returned to baseline levels 6 months after CAS.
Patients with CAS showed improved global cerebral hemodynamic status. However, the BRS did not normalize initially, and baseline value was achieved at 6 months after stenting.