Correlation between Hemodynamic Characteristics and Clinical Prognosis of Intracranial Collateral Circulation Opening in Patients with Severe carotid Artery Stenosis and Occlusion Assessed Noninvasively by TCD
10.13241/j.cnki.pmb.2025.13.014
- VernacularTitle:TCD无创评估颈动脉重度狭窄及闭塞患者颅内侧支循环开放的血流动力学特征与临床预后相关性研究
- Author:
Yang YANG
1
;
Xin WANG
1
;
Dan LEI
1
;
Dong-mei MA
1
;
Pei-li ZHANG
1
Author Information
1. 兰州大学第二医院神经血管功能检查科 甘肃兰州 730030
- Publication Type:Journal Article
- Keywords:
Transcranial Doppler;
Collateral circulation;
Hemodynamic parameters;
Clinical prognosis;
Carotid artery stenosis
- From:
Progress in Modern Biomedicine
2025;25(13):2195-2200,2207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the hemodynamic characteristics of intracranial collateral circulation assessed non-invasively by TCD and their correlation with clinical prognosis in patients with severe carotid stenosis or occlusion.Methods:A retrospective cohort study design was used to include 96 patients with severe stenosis(≥70％)or occlusion of the unilateral internal carotid artery admitted from March 2021 to March 2024,who were divided into a well-compensated group(58 patients)versus a poorly-compensated group(38 patients)based on the ASITN/SIR collateral branch score.Hemodynamic parameters(PSV,EDV,MFV,PI,RI)were measured using TCD,and collateral circulation status was validated by digital subtraction angiography(DSA).Prognosis was evaluated over a 12-month follow-up.Logistic regression was used to analyze risk factors for poor prognosis.Results:The good collateral group exhibited significantly higher PSV(82.32±18.51 vs.56.45±15.32 cm/s)and MFV(56.93±12.33 vs.35.89±9.83 cm/s),and significantly lower PI(0.64±0.15 vs.0.82±0.21)and RI(0.43±0.08 vs.0.51±0.11)compared to the poor collateral group(all P＜0.001).TCD parameters showed strong correlations with ASITN/SIR grades(PSV:r=0.62;PI:r=-0.61,all P＜0.001).Multivariate analysis identified age ≥65 years(OR=1.06),hypertension(OR=3.07),PI ≥ 1.00(OR=17.25),and PSV ≤ 60 cm/s(OR=1.96)as independent risk factors for poor prognosis(all P＜0.05).Conclusion:The TCD multi-parameter model enables quantitative assessment of collateral circulation function,with PI ≥ 1.00 and PSV ≤ 60 cm/s serving as key predictors of adverse outcomes.The non-invasive and dynamic monitoring advantages of TCD provide critical insights for hemodynamic stratification and personalized intervention in patients with carotid stenosis or occlusion.
