Effect of Cerebral Perfusion Status in Patients with Carotid Artery Stenosis on its Changes after Revascularizationтезисы доклада

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[1] Effect of cerebral perfusion status in patients with carotid artery stenosis on its changes after revascularization / A. N. Sergeeva, M. Krotenkova, R. Konovalov et al. // European Congress of Radiology 2017, Вена, Австрия. — 2017. Assessment of cerebral perfusion and collateral circulation in patients with carotid stenosis might have prognostic value for effective blood flow restoration after carotid revascularization.To assess cerebral perfusion in patients with carotid stenosis and to determine its changes after surgical or endovascular treatment. Perfusion CT was performed in 25 patients with artery carotid stenosis (50-99%) for 3 times: before intervention, 3-7 days and 1-3 months after treatment. CT perfusion study was done in 30 patients without carotid stenosis (control group). Mean transit time (MTT), cerebral blood volume (CBV), and cerebral blood flow (CBF) were calculated in the middle cerebral artery (MCA) area, watershed area between anterior cerebral artery and MCA territories (anterior watershed), and watershed area between posterior cerebral artery and MCA territories (posterior watershed) (Fig.1). We revealed two variants of perfusion changes in patients with carotid stenosis: increased MTT and CBV without CBF changes (first variant, n=8) and increased MTT and decreased CBF without CBV changes (second variant, n=17). After recanalization in both groups perfusion parameters in MCA area became similar to control group. In anterior and posterior watersheds in 3-7 days after treatment MTT and CBF improved in both groups (p=0.012, p=0.031 for MTT; p=0.035, p=0.006 for CBF). In 1-3 months all parameters in these areas returned to baseline and were different from control group (p=0.14 for MTT, p=0.3 for CBF) (Fig.1, Fig.2). Two variants of cerebral perfusion changes in patients with artery carotid stenosis were identified. Despite baseline perfusion status, cerebral perfusion parameters changed unidirectionally after intervention: improved in MCA area and did not change in watershed territories.

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