Flow redistribution in the major cerebral arteries after carotid endarterectomy: A study with transcranial Doppler scan E.M. Vriens, MD, PhD, G.H. Wieneke,

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Presentation transcript:

Flow redistribution in the major cerebral arteries after carotid endarterectomy: A study with transcranial Doppler scan E.M. Vriens, MD, PhD, G.H. Wieneke, PhD, B. Hillen, MD, PhD, B.C. Eikelboom, MD, PhD, A.C. Van Huffelen, MD, PhD, G.H. Visser, MD, PhD Journal of Vascular Surgery Volume 33, Issue 1, Pages 139-147 (January 2001) DOI: 10.1067/mva.2001.109768 Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Circle of Willis. Data from the side of surgery are reported on the left side ; data from the contralateral side are presented on the right side. ICA, Internal carotid artery; BA, basilar artery; MCA, middle cerebral artery; ACA-A1, anterior cerebral artery; PCA-P1, posterior cerebral artery; OA, ophthalmic artery; ACoA, anterior communicating artery; PCoA, posterior communicating artery; CEA, carotid endarterectomy. Journal of Vascular Surgery 2001 33, 139-147DOI: (10.1067/mva.2001.109768) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Blood flow velocity (cm/s) for different arteries and CO2 reactivity (CVR, [%]) for the total group. A, Preoperative values and B, changes after CEA are shown. *P <.05, ***P <.001, all with Wilcoxon matched-pairs signed-ranks test. Journal of Vascular Surgery 2001 33, 139-147DOI: (10.1067/mva.2001.109768) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Blood flow velocity (cm/s) for different arteries and CO2 reactivity (CVR, [%]) for three groups on the basis of contralateral stenosis. The first group is patients without hemodynamic contralateral ICA stenosis. The patients in the second group have 70% to 90% contralateral ICA stenosis. In patients in the last group, the contralateral ICA is occluded. A, Preoperative values and B, changes after CEA are shown. *P <.05, **P <.01, ***P <.001, all with Wilcoxon matched-pairs signed-ranks test. Significant difference between the groups is printed in bold (Kruskal-Wallis). CVRC, CO2 reactivity at the contralateral side; CVRCEA, CO2 reactivity at the side of surgery. Journal of Vascular Surgery 2001 33, 139-147DOI: (10.1067/mva.2001.109768) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Blood flow velocity (cm/s) for different arteries and CO2 reactivity (CVR, [%]) for two groups on the basis of shunt requirement. The first group consists of patients who needed a shunt because of intraoperative EEG changes. Patients in the second group did not need a shunt. A, Preoperative values and B, changes after CEA are shown. *P <.05, ***P <.001, all with Wilcoxon matched-pairs signed-ranks test. Significant difference between the groups is printed in bold (Mann-Whitney). CVRCEA, CO2 reactivity at the side of surgery; CVRCONTRA, CO2 reactivity at the contralateral side; EEG, electroencephalogram. Journal of Vascular Surgery 2001 33, 139-147DOI: (10.1067/mva.2001.109768) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions