Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis

Introduction The severity of internal carotid artery (ICA) atherosclerosis is assessed through measurements of degree of stenosis. This approach does not factor in mechanisms compensating for reduced distal perfusion, such as collateral circulation. An alternative approach is evaluating severity of...

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Main Authors: Matthew T Jones, Sebastian Sanchez, Rishi R Patel, Jacob M Miller, Ashrita Raghuram, Randy Kardon, Edgar Samaniego
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Stroke: Vascular and Interventional Neurology
Online Access:https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.255
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author Matthew T Jones
Sebastian Sanchez
Rishi R Patel
Jacob M Miller
Ashrita Raghuram
Randy Kardon
Edgar Samaniego
author_facet Matthew T Jones
Sebastian Sanchez
Rishi R Patel
Jacob M Miller
Ashrita Raghuram
Randy Kardon
Edgar Samaniego
author_sort Matthew T Jones
collection DOAJ
description Introduction The severity of internal carotid artery (ICA) atherosclerosis is assessed through measurements of degree of stenosis. This approach does not factor in mechanisms compensating for reduced distal perfusion, such as collateral circulation. An alternative approach is evaluating severity of carotid stenosis based on downstream changes in ocular perfusion. Laser speckle flowgraphy (LSFG) is a non‐invasive tool that quantifies intraocular blood flow. This pilot study investigated whether LSFG metrics could be surrogates for degree of stenosis. Additionally, we quantified changes in flow through the stenosed vessel before and after stenting usingsyngoiFlow (iFlow). Methods Fourteen patients had stents placed to treat symptomatic carotid stenosis. LSFG metrics were obtained before and after stenting. Mean blur rate (MBR), an index of ocular blood velocity, and associated waveform parameters were extracted from the optic nerve head (ONH) region of the eye. iFlow quantified time to peak (TTP), an index of peak cerebral contrast flow, by transforming digital subtraction angiography (DSA) images into perfusion heat maps.TTPswere extracted for seven regions of interest (ROIs) by two raters. Results Two LSFG waveform parameters were significantly negatively correlated with degree of stenosis. These parameters, flow acceleration index (FAI) and rising rate (RR), also increased significantly after stenting. Intraclass correlation coefficients calculated for TTPs showed substantial agreement across all ROIs. Significant decreases in TTP after stenting were observed in ROIs placed in the high cervical ICA, cavernous segment of the ICA, and brain parenchyma. Conclusions LSFG provides biometrics that can accurately measure the impact of ICA stenosis by quantifying distal perfusion. Indices of ocular blood flow acceleration may serve as surrogate metrics for degree of stenosis. iFlow is a sensitive tool to quantify changes in flow after stenting. Non‐invasive flow‐dependent methods are promising in the assessment of patients with ICA stenosis.
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spelling doaj.art-17b8463484ad49cdb87801b547d997782023-06-15T10:40:48ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.255Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid StenosisMatthew T Jones0Sebastian Sanchez1Rishi R Patel2Jacob M Miller3Ashrita Raghuram4Randy Kardon5Edgar Samaniego6The University of Iowa Hospital and Clinics Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Neurology Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Neurology Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Neurology Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Neurology Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Ophthalmology Iowa City Iowa United States of AmericaThe University of Iowa Hospitals and Clinics Department of Neurology Iowa City Iowa United States of AmericaIntroduction The severity of internal carotid artery (ICA) atherosclerosis is assessed through measurements of degree of stenosis. This approach does not factor in mechanisms compensating for reduced distal perfusion, such as collateral circulation. An alternative approach is evaluating severity of carotid stenosis based on downstream changes in ocular perfusion. Laser speckle flowgraphy (LSFG) is a non‐invasive tool that quantifies intraocular blood flow. This pilot study investigated whether LSFG metrics could be surrogates for degree of stenosis. Additionally, we quantified changes in flow through the stenosed vessel before and after stenting usingsyngoiFlow (iFlow). Methods Fourteen patients had stents placed to treat symptomatic carotid stenosis. LSFG metrics were obtained before and after stenting. Mean blur rate (MBR), an index of ocular blood velocity, and associated waveform parameters were extracted from the optic nerve head (ONH) region of the eye. iFlow quantified time to peak (TTP), an index of peak cerebral contrast flow, by transforming digital subtraction angiography (DSA) images into perfusion heat maps.TTPswere extracted for seven regions of interest (ROIs) by two raters. Results Two LSFG waveform parameters were significantly negatively correlated with degree of stenosis. These parameters, flow acceleration index (FAI) and rising rate (RR), also increased significantly after stenting. Intraclass correlation coefficients calculated for TTPs showed substantial agreement across all ROIs. Significant decreases in TTP after stenting were observed in ROIs placed in the high cervical ICA, cavernous segment of the ICA, and brain parenchyma. Conclusions LSFG provides biometrics that can accurately measure the impact of ICA stenosis by quantifying distal perfusion. Indices of ocular blood flow acceleration may serve as surrogate metrics for degree of stenosis. iFlow is a sensitive tool to quantify changes in flow after stenting. Non‐invasive flow‐dependent methods are promising in the assessment of patients with ICA stenosis.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.255
spellingShingle Matthew T Jones
Sebastian Sanchez
Rishi R Patel
Jacob M Miller
Ashrita Raghuram
Randy Kardon
Edgar Samaniego
Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
Stroke: Vascular and Interventional Neurology
title Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
title_full Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
title_fullStr Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
title_full_unstemmed Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
title_short Abstract Number ‐ 255: Laser Speckle Flowgraphy As A Surrogate Marker For Symptomatic Carotid Stenosis
title_sort abstract number 255 laser speckle flowgraphy as a surrogate marker for symptomatic carotid stenosis
url https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.255
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