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Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion

(1) Background: Carotid artery occlusion (CAO) in population studies has a reported prevalence of about 6 per 100,000 people; however, the data may be underestimated. CAO carries a significant risk of stroke. Up to 15% of large artery infractions may be secondary to the CAO, and in 27–38% of patient...

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Autores principales: Kaszczewski, Piotr, Elwertowski, Michał, Leszczyński, Jerzy, Ostrowski, Tomasz, Kaszczewska, Joanna, Gałązka, Zbigniew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947284/
https://www.ncbi.nlm.nih.gov/pubmed/35328320
http://dx.doi.org/10.3390/diagnostics12030766
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author Kaszczewski, Piotr
Elwertowski, Michał
Leszczyński, Jerzy
Ostrowski, Tomasz
Kaszczewska, Joanna
Gałązka, Zbigniew
author_facet Kaszczewski, Piotr
Elwertowski, Michał
Leszczyński, Jerzy
Ostrowski, Tomasz
Kaszczewska, Joanna
Gałązka, Zbigniew
author_sort Kaszczewski, Piotr
collection PubMed
description (1) Background: Carotid artery occlusion (CAO) in population studies has a reported prevalence of about 6 per 100,000 people; however, the data may be underestimated. CAO carries a significant risk of stroke. Up to 15% of large artery infractions may be secondary to the CAO, and in 27–38% of patients, ischaemic stroke is a first presentation of the disease. The presence of sufficient and well-developed collateral circulation has a protective influence, being a good prognostic factor in patients with carotid artery disease, both chronic and acute. Understanding the mechanisms and role of collateral circulation may be very important in the risk stratification of such patients. (2) Materials and Methods: This study included 46 patients (mean age: 70.5 ± 6 years old; 15 female, mean age 68.5 ± 3.8 years old and 31 male, mean age 71.5 ± 6.7 years old) with unilateral or bilateral ICA occlusion. In all patients, a Doppler ultrasound (DUS) examination, measuring blood flow volume in the internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA), was performed. The cerebral blood flow (CBF) was compared to the previously reported CBF values in the healthy population >65 years old. (3) Results: In comparison with CBF values in the healthy population, three subgroups with CBF changes were identified among patients with ICA occlusion: patients with significant volumetric flow compensation (CBF higher than average + standard deviation for healthy population of the same age), patients with flow similar to the healthy population (average ± standard deviation), and patients without compensation (CBF lower than the average-standard deviation for healthy population). The percentage of patients with significant volumetric flow compensation tend to rise with increasing age, while a simultaneous decline was observed in the group without compensation. The percentage of patients with flow similar to the healthy population remained relatively unchanged. ICA played the most important role in volumetric flow compensation in patients with CAO; however, the relative increase in flow in the ICA was smaller than that in the ECA and VA. Compensatory increased flow was observed in about 50% of all patent extracranial arteries and was more frequently observed in ipsilateral vessels than in contralateral ones, in both the ECA and the VA. In patients with CAO, there was no decrease in CBF, ICA, ECA, and VA flow volume with increasing age. (4) Conclusions: Volumetric flow compensation may play an important predictive role in patients with CAO.
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spelling pubmed-89472842022-03-25 Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion Kaszczewski, Piotr Elwertowski, Michał Leszczyński, Jerzy Ostrowski, Tomasz Kaszczewska, Joanna Gałązka, Zbigniew Diagnostics (Basel) Article (1) Background: Carotid artery occlusion (CAO) in population studies has a reported prevalence of about 6 per 100,000 people; however, the data may be underestimated. CAO carries a significant risk of stroke. Up to 15% of large artery infractions may be secondary to the CAO, and in 27–38% of patients, ischaemic stroke is a first presentation of the disease. The presence of sufficient and well-developed collateral circulation has a protective influence, being a good prognostic factor in patients with carotid artery disease, both chronic and acute. Understanding the mechanisms and role of collateral circulation may be very important in the risk stratification of such patients. (2) Materials and Methods: This study included 46 patients (mean age: 70.5 ± 6 years old; 15 female, mean age 68.5 ± 3.8 years old and 31 male, mean age 71.5 ± 6.7 years old) with unilateral or bilateral ICA occlusion. In all patients, a Doppler ultrasound (DUS) examination, measuring blood flow volume in the internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA), was performed. The cerebral blood flow (CBF) was compared to the previously reported CBF values in the healthy population >65 years old. (3) Results: In comparison with CBF values in the healthy population, three subgroups with CBF changes were identified among patients with ICA occlusion: patients with significant volumetric flow compensation (CBF higher than average + standard deviation for healthy population of the same age), patients with flow similar to the healthy population (average ± standard deviation), and patients without compensation (CBF lower than the average-standard deviation for healthy population). The percentage of patients with significant volumetric flow compensation tend to rise with increasing age, while a simultaneous decline was observed in the group without compensation. The percentage of patients with flow similar to the healthy population remained relatively unchanged. ICA played the most important role in volumetric flow compensation in patients with CAO; however, the relative increase in flow in the ICA was smaller than that in the ECA and VA. Compensatory increased flow was observed in about 50% of all patent extracranial arteries and was more frequently observed in ipsilateral vessels than in contralateral ones, in both the ECA and the VA. In patients with CAO, there was no decrease in CBF, ICA, ECA, and VA flow volume with increasing age. (4) Conclusions: Volumetric flow compensation may play an important predictive role in patients with CAO. MDPI 2022-03-21 /pmc/articles/PMC8947284/ /pubmed/35328320 http://dx.doi.org/10.3390/diagnostics12030766 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaszczewski, Piotr
Elwertowski, Michał
Leszczyński, Jerzy
Ostrowski, Tomasz
Kaszczewska, Joanna
Gałązka, Zbigniew
Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title_full Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title_fullStr Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title_full_unstemmed Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title_short Intracranial Flow Volume Estimation in Patients with Internal Carotid Artery Occlusion
title_sort intracranial flow volume estimation in patients with internal carotid artery occlusion
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947284/
https://www.ncbi.nlm.nih.gov/pubmed/35328320
http://dx.doi.org/10.3390/diagnostics12030766
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