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Predictors of poor cerebral collaterals and cerebrovascular reserve in patients with chronic total carotid occlusion.
- Source :
-
The International journal of neuroscience [Int J Neurosci] 2019 May; Vol. 129 (5), pp. 455-460. Date of Electronic Publication: 2018 Nov 27. - Publication Year :
- 2019
-
Abstract
- Background: This study aims to investigate the relationship between cerebrovascular reserve (CVR) capacity, as measured by single-photon emission computed tomography (SPECT) and collateral blood flow, according to a transcranial colour-coded duplex(TCCD), in patients with symptomatic total carotid occlusion (TCO). Additionally, the study aims to determine whether vascular risk factors have an effect on collateral blood flow, as well as on the CVR.<br />Methods: Thirty-four patients with chronic TCO, diagnosed by carotid duplex scanning and confirmed by other vascular imaging modalities, who had ischaemic symptoms either as stroke or transient ischaemic attack, were subjected to clinical assessment, SPECT under dipyridamole stress, and grading of cerebral collateral blood flow using TCCD. Demographics and vascular risk factors were correlated with SPECT and TCCD findings.<br />Results: CVR showed a significant positive correlation with the intensity of collaterals with P value <0.001 and a Spearman correlation coefficient of 0.686. Hypertension was the only predictor of poor collaterals (p value =0.049; OR =11.5 with 95% CI 1.01-131.16).Smoking was predictive of poor CVR as measured by qualitative SPECT (p value =0.02; OR =13.2 with 95% CI 1.4-120.6).<br />Conclusion: Cerebral collaterals have an important role in the maintenance of CVR in patients with TCO. Preventive measures should be directed towards hypertension and smoking to preserve cerebral collateral patency and consequently improve CVR in patients with TCO.
- Subjects :
- Adult
Aged
Carotid Artery Diseases physiopathology
Carotid Stenosis physiopathology
Female
Humans
Ischemic Attack, Transient physiopathology
Male
Middle Aged
Stroke physiopathology
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Transcranial methods
Carotid Artery Diseases diagnostic imaging
Carotid Stenosis diagnostic imaging
Cerebrovascular Circulation physiology
Collateral Circulation physiology
Ischemic Attack, Transient diagnostic imaging
Stroke diagnostic imaging
Tomography, Emission-Computed, Single-Photon methods
Subjects
Details
- Language :
- English
- ISSN :
- 1563-5279
- Volume :
- 129
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The International journal of neuroscience
- Publication Type :
- Academic Journal
- Accession number :
- 30372650
- Full Text :
- https://doi.org/10.1080/00207454.2018.1538990