Monitoring of microembolism and cerebral blood flow before, after and during carotid angioplasty and stenting with filter devices
- VernacularTitle:滤器保护的颈动脉支架成形术的微栓子和脑血流监测
- Author:
Wei SUN
;
Yining HUANG
;
Min YANG
;
Yinghua ZOU
- Publication Type:Journal Article
- Keywords:
Carotid stenosis;
Angioplasty;
Stents;
Blood flow velocity
- From:
Chinese Journal of Neurology
2005;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
70%). TCD monitored the microembolic signals (MES) and cerebral blood flow of middle cerebral artery (MCA) using M-Mode before, after and during CAS. TCD and color ultrasound duplex were examined and new vascular events recorded during the following-up. Results Except a large numbers of MES arising from the recent contrast injection, the most MES were detected during the phase of predilation (MES number=116) and stent placement (MES number=135, 91, 113, 90, 106, 125). The MES count during the phase of postdilation was relatively reduced (MES number=8, 14, 37, 16). The most MES were characterized by high intensity and over-loading in TCD spectrum. MCA blood flow velocity varied predominantly in phases of predilation (Vsys/Vmean=46/31 to 76/54) and postdilation (Vsys/Vmean=40/26 to 74/49, 0/0 to 114/69, 35/24 to 116/71, 50/36 to 137/86). MES recorded in 2 patients prior to CAS disappeared in post-procedure. MCA blood flow velocity was enhanced or MCA pulsative index increased after CAS. No complications occurred. Tissue debris was collected in one filter device. During 3 to 19 months following-up, only one patient had a new vascular event of cerebral infarction located in the contralateral side of the CAS. Conclusions TCD monitoring might evaluate the microemboli and cerebral blood flow before, after and during CAS with filter devices. Filter devices might reduce embolization by preventing the bigger particulate microembolism into the distal part of the cerebral vessel without influencing cerebral blood flow. The gaseous and the smaller particulate microembolism unfiltrated should not result in clinical symptoms in most cases.
