Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease
Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
SAGE Publications
2017
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| _version_ | 1797097664223903744 |
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| author | Hartkamp, N Petersen, E Chappell, M Okell, T Uyttenboogaart, M Zeebregts, C Bokkers, R |
| author_facet | Hartkamp, N Petersen, E Chappell, M Okell, T Uyttenboogaart, M Zeebregts, C Bokkers, R |
| author_sort | Hartkamp, N |
| collection | OXFORD |
| description | Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres were compromised. Haemodynamic impairment in the affected brain region was always present in symptomatic patients. The degree of collateral blood flow was inversely correlated with haemodynamic impairment. Recruitment of secondary collaterals only occurred in symptomatic ICA occlusion patients. In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment. |
| first_indexed | 2024-03-07T04:58:42Z |
| format | Journal article |
| id | oxford-uuid:d782944e-7888-4afb-831e-3881e9f07e11 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:58:42Z |
| publishDate | 2017 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:d782944e-7888-4afb-831e-3881e9f07e112022-03-27T08:41:42ZRelationship between haemodynamic impairment and collateral blood flow in carotid artery diseaseJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d782944e-7888-4afb-831e-3881e9f07e11EnglishSymplectic Elements at OxfordSAGE Publications2017Hartkamp, NPetersen, EChappell, MOkell, TUyttenboogaart, MZeebregts, CBokkers, RCollateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres were compromised. Haemodynamic impairment in the affected brain region was always present in symptomatic patients. The degree of collateral blood flow was inversely correlated with haemodynamic impairment. Recruitment of secondary collaterals only occurred in symptomatic ICA occlusion patients. In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment. |
| spellingShingle | Hartkamp, N Petersen, E Chappell, M Okell, T Uyttenboogaart, M Zeebregts, C Bokkers, R Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title | Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title_full | Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title_fullStr | Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title_full_unstemmed | Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title_short | Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
| title_sort | relationship between haemodynamic impairment and collateral blood flow in carotid artery disease |
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