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Quantitative assessment of changes in hemodynamics of the internal carotid artery after bypass surgery for moyamoya disease
- Source :
- Journal of neurosurgery. 129(3)
- Publication Year :
- 2017
-
Abstract
- OBJECTIVEAlthough intracranial vessel remodeling has been observed in moyamoya disease, concerns remain regarding the effect of bypass surgery on hemodynamic changes within the internal carotid artery (ICA). The authors aimed to quantify the surgical effect of bypass surgery on bilateral ICAs in moyamoya disease and to estimate pressure drop (PD) along the length of the ICA to predict surgical outcomes.METHODSRecords of patients who underwent bypass surgery for treatment of moyamoya disease and in whom flow rates were obtained pre- and postsurgery by quantitative MR angiography were retrospectively reviewed. Quantitative MR angiography and computational fluid dynamics were applied to measure morphological and hemodynamic changes during pre- and postbypass procedures. The results for vessel diameter, volumetric flow, PD, and mean wall shear stress along the length of the ICA were analyzed. Subgroup analysis was performed for the circle of Willis (CoW) configurations.RESULTSTwenty-three patients were included. The PD in ICAs on the surgical side (surgical ICAs) decreased by 21.18% (SD ± 30.1%) and increased by 11.75% (SD ± 28.6%) in ICAs on the nonsurgical side (contralateral ICAs) (p = 0.001). When the PD in contralateral ICAs was compared between patients with a complete or incomplete CoW, the authors found that the PDI in the former group decreased by 2.45% and increased by 20.88% in the latter (p = 0.05). Regression tests revealed that a greater postoperative decrease in PD corresponded to shrinking of ICAs (R2 = 0.22, p = 0.02).CONCLUSIONSPD may be used as a reliable biomechanical indicator for the assessment of surgical treatment outcomes. The vessel remodeling characteristics of contralateral ICA were related to CoW configurations.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Hemodynamics
Subgroup analysis
Blood Pressure
030204 cardiovascular system & hematology
Magnetic resonance angiography
03 medical and health sciences
Young Adult
0302 clinical medicine
Postoperative Complications
Reference Values
medicine.artery
Internal medicine
medicine
Humans
Moyamoya disease
medicine.diagnostic_test
business.industry
General Medicine
Middle Aged
medicine.disease
Treatment Outcome
Bypass surgery
Angiography
Cardiology
Circle of Willis
Female
Radiology
Internal carotid artery
Moyamoya Disease
business
030217 neurology & neurosurgery
Blood Flow Velocity
Carotid Artery, Internal
Magnetic Resonance Angiography
Subjects
Details
- ISSN :
- 19330693
- Volume :
- 129
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of neurosurgery
- Accession number :
- edsair.doi.dedup.....cd15f44bff56c7b6db13a2bb0958e9a8