Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow

Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. Objective To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. Materials and methods We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS). Using 123 I-iodamphetamine single-photon emission computed tomography (SPECT); we compared pre-and postoperative hemispheric CBF on both sides. We investigated the influence of the following five factors on the increase of the contralateral hemispheric CBF: stenosis grade (≥50% or <50%, according to the North American Symptomatic Carotid Endarterectomy Trial criteria); age; the presence of anterior and posterior communicating arteries; postoperative hyperperfusion on the stenotic side; and the presence of cerebral steal phenomenon during preoperative acetazolamide-challenge SPECT. Results Following unilateral CAS, mean hemispheric CBF increased significantly on both sides: from 33.4±5.6 (mean ± SD) to 38.7±7.8 mL/min on the operated side (paired t test, p<0.001) and f35.4±5.4 to 39.2±7.2 mL/min on the contralateral side (p<0.001). In a general linear model, stenosis grade (≥50%) alone was significantly correlated with the increase of the CBF on the contralateral side (p=0.03). Conclusion Revascularization by CAS for unilateral carotid stenosis can increase hemispheric CBF on both sides. Increase of the contralateral CBF is correlated with stenosis grade (≥50%).

Original languageEnglish
Pages (from-to)351-353
Number of pages3
JournalJournal of NeuroInterventional Surgery
Volume10
Issue number4
DOIs
Publication statusPublished - 01-04-2018

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Cerebrovascular Circulation
Pathologic Constriction
Carotid Stenosis
Carotid Arteries
Single-Photon Emission-Computed Tomography
Acetazolamide
Carotid Endarterectomy
Linear Models
Arteries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Sadato, Akiyo ; Maeda, Shingo ; Hayakawa, Motoharu ; Adachi, Kazuhide ; Toyama, Hiroshi ; Nakahara, Ichiro ; Hirose, Yuichi. / Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow. In: Journal of NeuroInterventional Surgery. 2018 ; Vol. 10, No. 4. pp. 351-353.
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title = "Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow",
abstract = "Background The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. Objective To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. Materials and methods We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS). Using 123 I-iodamphetamine single-photon emission computed tomography (SPECT); we compared pre-and postoperative hemispheric CBF on both sides. We investigated the influence of the following five factors on the increase of the contralateral hemispheric CBF: stenosis grade (≥50{\%} or <50{\%}, according to the North American Symptomatic Carotid Endarterectomy Trial criteria); age; the presence of anterior and posterior communicating arteries; postoperative hyperperfusion on the stenotic side; and the presence of cerebral steal phenomenon during preoperative acetazolamide-challenge SPECT. Results Following unilateral CAS, mean hemispheric CBF increased significantly on both sides: from 33.4±5.6 (mean ± SD) to 38.7±7.8 mL/min on the operated side (paired t test, p<0.001) and f35.4±5.4 to 39.2±7.2 mL/min on the contralateral side (p<0.001). In a general linear model, stenosis grade (≥50{\%}) alone was significantly correlated with the increase of the CBF on the contralateral side (p=0.03). Conclusion Revascularization by CAS for unilateral carotid stenosis can increase hemispheric CBF on both sides. Increase of the contralateral CBF is correlated with stenosis grade (≥50{\%}).",
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Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow. / Sadato, Akiyo; Maeda, Shingo; Hayakawa, Motoharu; Adachi, Kazuhide; Toyama, Hiroshi; Nakahara, Ichiro; Hirose, Yuichi.

In: Journal of NeuroInterventional Surgery, Vol. 10, No. 4, 01.04.2018, p. 351-353.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow

AU - Sadato, Akiyo

AU - Maeda, Shingo

AU - Hayakawa, Motoharu

AU - Adachi, Kazuhide

AU - Toyama, Hiroshi

AU - Nakahara, Ichiro

AU - Hirose, Yuichi

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. Objective To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. Materials and methods We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS). Using 123 I-iodamphetamine single-photon emission computed tomography (SPECT); we compared pre-and postoperative hemispheric CBF on both sides. We investigated the influence of the following five factors on the increase of the contralateral hemispheric CBF: stenosis grade (≥50% or <50%, according to the North American Symptomatic Carotid Endarterectomy Trial criteria); age; the presence of anterior and posterior communicating arteries; postoperative hyperperfusion on the stenotic side; and the presence of cerebral steal phenomenon during preoperative acetazolamide-challenge SPECT. Results Following unilateral CAS, mean hemispheric CBF increased significantly on both sides: from 33.4±5.6 (mean ± SD) to 38.7±7.8 mL/min on the operated side (paired t test, p<0.001) and f35.4±5.4 to 39.2±7.2 mL/min on the contralateral side (p<0.001). In a general linear model, stenosis grade (≥50%) alone was significantly correlated with the increase of the CBF on the contralateral side (p=0.03). Conclusion Revascularization by CAS for unilateral carotid stenosis can increase hemispheric CBF on both sides. Increase of the contralateral CBF is correlated with stenosis grade (≥50%).

AB - Background The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. Objective To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. Materials and methods We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS). Using 123 I-iodamphetamine single-photon emission computed tomography (SPECT); we compared pre-and postoperative hemispheric CBF on both sides. We investigated the influence of the following five factors on the increase of the contralateral hemispheric CBF: stenosis grade (≥50% or <50%, according to the North American Symptomatic Carotid Endarterectomy Trial criteria); age; the presence of anterior and posterior communicating arteries; postoperative hyperperfusion on the stenotic side; and the presence of cerebral steal phenomenon during preoperative acetazolamide-challenge SPECT. Results Following unilateral CAS, mean hemispheric CBF increased significantly on both sides: from 33.4±5.6 (mean ± SD) to 38.7±7.8 mL/min on the operated side (paired t test, p<0.001) and f35.4±5.4 to 39.2±7.2 mL/min on the contralateral side (p<0.001). In a general linear model, stenosis grade (≥50%) alone was significantly correlated with the increase of the CBF on the contralateral side (p=0.03). Conclusion Revascularization by CAS for unilateral carotid stenosis can increase hemispheric CBF on both sides. Increase of the contralateral CBF is correlated with stenosis grade (≥50%).

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U2 - 10.1136/neurintsurg-2017-013193

DO - 10.1136/neurintsurg-2017-013193

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VL - 10

SP - 351

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JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

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