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11.09.2017 | Magnetic Resonance

Effective collateral circulation may indicate improved perfusion territory restoration after carotid endarterectomy

verfasst von: Tianye Lin, Zhichao Lai, Yuelei Lv, Jianxun Qu, Zhentao Zuo, Hui You, Bing Wu, Bo Hou, Changwei Liu, Feng Feng

Erschienen in: European Radiology | Ausgabe 2/2018

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Abstract

Objectives

To investigate the relationship between the level of collateral circulation and perfusion territory normalisation after carotid endarterectomy (CEA).

Methods

This study enrolled 22 patients with severe carotid stenosis that underwent CEA and 54 volunteers without significant carotid stenosis. All patients were scanned with ASL and t-ASL within 1 month before and 1 week after CEA. Collateral circulation was assessed on preoperative ASL images based on the presence of ATA. The postoperative flow territories were considered as back to normal if they conformed to the perfusion territory map in a healthy population. Neuropsychological tests were performed on patients before and within 7 days after surgery.

Results

ATA-based collateral score assessed on preoperative ASL was significantly higher in the flow territory normalisation group (n=11, 50 %) after CEA (P < 0.0001). The MMSE (mean change=1.36±0.96) and MOCA (mean change=1.18±0.95) test scores showed a significant postoperative (7 days after CEA) improvement in the flow territory normalisation group [>mean differences+2SD among control (MMSE=1.35, MOCA=1.02)].

Conclusions

This study demonstrated that effective collateral flow in carotid stenosis patients was associated with normalisation of t-ASL perfusion territory after CEA. The perfusion territory normalisation group tends to have more cognitive improvement after CEA.

Key Points

• Evaluation of collaterals before CEA is helpful for avoiding ischaemia during clamping.

• There was good agreement on ATA-based ASL collateral grading.

• Perfusion territories in carotid stenosis patients are altered.

• Patients have better collateral circulation with perfusion territory back to normal.

• MMSE and MOCA test scores improved more in the territory normalisation group.

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Titel: Effective collateral circulation may indicate improved perfusion territory restoration after carotid endarterectomy
verfasst von: Tianye Lin
Zhichao Lai
Yuelei Lv
Jianxun Qu
Zhentao Zuo
Hui You
Bing Wu
Bo Hou
Changwei Liu
Feng Feng
Publikationsdatum: 11.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5020-8

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Effective collateral circulation may indicate improved perfusion territory restoration after carotid endarterectomy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Abstract

Objectives

Methods

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Conclusions

Key Points

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