Effect of carotid artery stenting on cerebral blood flow and cerebrovascular reactivity in patients with internal carotid artery stenosis

Abstract

Objective To analyze the effect of carotid artery stenting (CAS) on cerebral blood flow and cerebrovascular reactivity in patients with severe carotid stenosis. Methods Twenty patients with unilateral severe internal carotid artery stenosis, conformed by carotid color ultrasonography or MR angiography in our hospital from August 2014 to December 2015, were chosen in our study. CAS was performed; relative cerebral blood flow (rCBF) detection and relative cerebrovascular reactivity (rCVR) assessment were performed by single photon emission computed tomography (SPECT) combined with carbon dioxide (CO2) inhalation within one week before surgery and 3 months after surgery. Four regions of interest (ROIs) in the bilateral middle cerebral artery (MCA) territory of internal carotid stenosis were selected for data analysis. The changes of rCBF and rCVR before and after CAS between the ipsilateral and contralateral ROIs of these patients were compared. Results In these 20 patients, 80 ROIs from each patient were obtained. Preoperative ipsilateral rCBF averaged 0.883±0.075, and contralateral rCBF averaged 0.929±0.033; preoperative ipsilateral rCVR averaged 0.010±0.055, and contralateral rCBF averaged 0.124±0.053; postoperative ipsilateral rCBF and rCVR averaged 0.927±0.040 and 0.092±0.058, and contralateral rCBF averaged 0.938±0.038 and 0.127±0.054. Postoperative ipsilateral rCBF and rCVR were significantly improved as compared with preoperative ones (P 0.05). Conclusions CAS can not only improve rCBF and rCVR of the MCA in the carotid artery stenosis, but also improve the contralateral side. Key words: Carotid angioplasty and stenting; Cerebral blood flow; Cerebrovascular reactivity; Single photon emission computed tomography