Dynamic observation of cerebral vasoreactivity after carotid angioplasty and stenting

Abstract

Objective To explore the changes and influencing factors of cerebral vasoreactivity （CVR） in patients after carotid angioplasty and stenting （CAS）. Methods Thirty-seven patients performed CAS, admitted to our hospital from July 2008 to September 2009, were finished the follow-up and chosen in our study; the breath-holding index （BHI） of the bilateral middle cerebral artery was measured using transcranial Doppler combined with breath holding test before thc operation, and 1 d and 3-10 months after the operation. Repeated measures design analysis of variance was employed to detect the BHI changes before and after the stenting; multiple regression was employed to analyze the influencing factors of BHI. Results BHI values after stenting were significantly higher than those before stenting on the stenotic side （P〈0.05）. The follow-up BHI values were negatively correlated with those of tandem stenoses （β=-0.016, P=0.002） and positively correlated with the postoperative BHI values （β=1.030, P=0.000）. Conclusion CAS can immediately improve CVR on the ipsilateral side and make it close to normalization gradually. Tandem stenoses are the independent risk factors of CVR. Key words: Carotid artery stenosis; Carotid angioplasty and stenting; Breath-holding index; Follow-up