Changes in chorioretinal blood flow velocity and cerebral blood flow after carotid endarterectomy.

Abstract

To investigate the changes in chorioretinal blood flow velocity and cerebral blood after carotid endarterectomy (CEA). Nine patients with moderate to severe internal carotid artery stenosis underwent CEA. Chorioretinal blood flow velocity was measured by laser speckle flowgraphy (LSFG), while cerebral blood flow (CBF) was measured by single-photon emission computed tomography (SPECT), on the affected side both before and after CEA. LSFG was evaluated in five areas to determine mean blur rate, while CBF was calculated from regional CBF and cerebrovascular reactivity (CVR), at the middle cerebral artery (MCA) region of each patient. Five cases showed an increase (mean 3.49%, range -29.82 to 35.59%) of average chorioretinal blood flow velocity using LSFG after CEA. A particularly averaged increase in chorioretinal blood flow was observed in the macular area compared with other areas. Similarly, there was an increase in CBF at rest (mean 11.46%, range -14.51 to 74.14%) observed using SPECT after surgery. Improvement of CVR was confirmed in four cases. All general and visual symptoms disappeared after CEA. Severe adverse effects, including hyperperfusion syndrome, were not observed in any cases. LSFG may be useful for the analysis of chorioretinal blood flow changes after CEA.