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Titolo:
Cerebral hemodynamics in patients with carotid artery occlusion and contralateral moderate or severe internal carotid artery stenosis
Autore:
Vernieri, F; Pasqualetti, P; Diomedi, M; Giacomini, P; Rossini, PM; Caltagirone, C; Silvestrini, M;
Indirizzi:
Assoc Fatebenefratelli Ric, Rome, Italy Assoc Fatebenefratelli Ric Rome Italy Fatebenefratelli Ric, Rome, Italy Fatebenefratelli Hosp, Dept Neurosci, Rome, Italy Fatebenefratelli Hosp Rome Italy telli Hosp, Dept Neurosci, Rome, Italy Univ Rome Tor Vergata, Neurol Clin, Rome, Italy Univ Rome Tor Vergata Rome Italy Tor Vergata, Neurol Clin, Rome, Italy Univ La Sapienza, Neurol Clin, Rome, Italy Univ La Sapienza Rome ItalyUniv La Sapienza, Neurol Clin, Rome, Italy Ist Ric & Cura Carattere Sci, Rome, Italy Ist Ric & Cura Carattere Sci Rome Italy Cura Carattere Sci, Rome, Italy Univ Ancona, Neurol Clin, Torrette Di Ancona, Italy Univ Ancona Torrette Di Ancona Italy ol Clin, Torrette Di Ancona, Italy
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 4, volume: 94, anno: 2001,
pagine: 559 - 564
SICI:
0022-3085(200104)94:4<559:CHIPWC>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCRANIAL DOPPLER ULTRASOUND; COLLATERAL BLOOD-FLOW; CEREBROVASCULAR REACTIVITY; VASOMOTOR REACTIVITY; STROKE RISK; DISEASE; ENDARTERECTOMY; INFARCTION; PROGNOSIS; PATTERN;
Keywords:
carotid artery occlusion; cerebral hemodynamics; transcranial Doppler ultrasonography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Silvestrini, M Univ Ancona, Azienda Osped Umberto I, Neurol Clin, Via Conca 1, I-60020 Torrette Di Ancona, Italy Univ Ancona Via Conca 1 Torrette Di Ancona Italy I-60020 y
Citazione:
F. Vernieri et al., "Cerebral hemodynamics in patients with carotid artery occlusion and contralateral moderate or severe internal carotid artery stenosis", J NEUROSURG, 94(4), 2001, pp. 559-564

Abstract

Object. The purpose of this study was to evaluate cerebral hemodynamics inpatients suffering from occlusion of the carotid artery (CA) and contralateral CA stenosis. Methods. Using transcranial Doppler ultrasonography, the cerebrovascular reactivity to hypercapnia in the middle cerebral arteries was evaluated by calculating the breath-holding index (BHI) of 69 symptomatic patients suffering from internal CA (ICA) occlusion and moderate or severe contralateral ICA stenosis. To evaluate which variables influenced BHIs ipsilateral to thesite of ICA occlusion, a multiple stepwise linear regression analysis was performed that included the following factors: patient age, percentage of contralateral ICA stenosis, contralateral BHI, number of collateral pathways, and presence of hypertension, diabetes, smoking, and hyperlipidemia. An analysis of variance was conducted to evaluate the impact of the type of collateral vessels on the BHI. A regression analysis showed that the BHI ipsilateral to the site of ICA occlusion could be accounted for by the contralateral BHI (which was entered at the first step of the analysis, p < 0.001) and by the number of collateral pathways (which was entered at the second step, p = 0.033). Neither the degree of contralateral ICA stenosis nor the other variables could be added to improve the model. The analysis demonstrated that the absence of collateral pathways and the presence of the anterior communicating artery (ACoA) alone were associated with lower BHI values than those found in the presence of two or three collateral vessels, regardless of the presence of an anterior collateral pathway. Conclusions. On the basis of these data one can infer that the cerebral hemodynamic status of patients with occlusive disease of the CA is influencedby individual anatomical and functional characteristics. Because improvement in contralateral hemodynamics after surgical correction of an ICA stenosis can only be expected in the presence of an ACoA, the planning of strategies for influencing cerebral blood flow distal to an ICA occlusion and, in particular, the consideration of a contralateral carotid endarterectomy, should be preceded by a careful evaluation of the intracranial hemodynamic adaptive status of the patient. Particular attention should be paid to cerebrovascular reactivity and the number and type of collateral Vessels that arepresent.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 22:21:57