Evaluation of circle of Willis function in patients with severe unilateral carotid artery stenosis Influence of decision-making on revascularization
10.19845/j.cnki.zfysjjbzz.2022.0182
- VernacularTitle:Willis环不同mTICI代偿分级对单侧颈动脉重度狭窄患者血管重建术的决策影响
- Author:
Hongfeng WEN
1
;
Daquan HE
1
;
Yu CHEN
1
Author Information
1. Department of Neurology,Aerospace Center Hospital,Beijing 100049,China
- Publication Type:Journal Article
- Keywords:
Carotid stenosis;
Circle of Willis;
CT perfusion;
Carotid artery stenting
- From:
Journal of Apoplexy and Nervous Diseases
2022;39(8):727-730
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the difference of cerebral blood perfusion in patients with severe unilateral carotid artery stenosis by CTA,CTP and DSA combined assessment of circle of Willis (CoW) different mTICI compensatory grades.Methods Sixty-five patients with unilateral carotid artery stenosis≥70% were selected according to CTA,and CTP.Among them,33 patients were confirmed by carotid compression test to have compensated blood supply to the stenosis side through anterior communicating artery and/or posterior communicating artery (mTICI ≥2b),which was called as the well compensated CoW group.The other 32 cases were confirmed by neck compression test that there was no compensatory blood supply to the stenosis side,or inadequate compensation (mTICI ≤2a) was called the poor compensatory CoW group.All patients were given internal carotid artery stenting (CAS) for severe internal carotid artery (ICA) stenosis,and the residual stenosis was ≤30%.CTP examination was completed in all patients within 3 months after operation.The relative cerebral blood volume (rCBV),relative cerebral blood flow (rCBF),relative mean transit time (rMTT) and relative peak time (rTTP) of the middle cerebral artery blood supply area before and after operation were measured and calculated.The self-comparison of perfusion parameters before and after operation and the transverse comparison between the two groups.Results There were significant differences in rMTT,rTTP and slightly increased rCBV in the poor compensated CoW group before stenting than the well compensated CoW group(P<0.05),but the difference in rCBF was not significant (P=0.14).After stenting,there were no significant differences in rCBV,rCBF,rMTT,and rTTP between the two groups (P>0.05).There was only no significant difference in rCBF between the two groups before and after stenting (P>0.05).Conclusion For patients with severe unilateral carotid artery stenosis,different compensatory functions of Willis can significantly change the distribution of cerebral blood flow,providing a reference for the choice of carotid artery stent implantation.
- Full text:2024072322553871169Evaluation of circle of Willis function in patients with severe unilateral carotid artery stenosis Influence of decision-making on revascularization.pdf
