Article Figures & Data
Figures
- Figure 1
Images obtained of a 56-year-old man who manifested with transient right hemiparesis due to cerebral hypoperfusion caused by near occlusion carotid artery. (A) CT angiography showing near occlusion at the ICA origin; (B) right carotid angiography before angioplasty showing near occlusion at the ICA origin; (C) CTP scan in the resting state showing that CBF is severely decreased, CBV, MTT and TTP in the right cerebral hemisphere are severely increased. CTP, CT perfusion; CBF, cerebral blood flow; CBV, cerebral blood volume; ICA, internal carotid artery; MTT, mean transit time; TTP, time to peak.
- Figure 2
Images obtained in a 56-year-old man who manifested with transient right hemiparesis due to cerebral hypoperfusion caused by near occlusion of the carotid artery. (A) Fluoroscopy during angioplasty showing that the target ICA stenosis was dilated by the balloon (diameter 2 mm, 8 atm for 30 s); (B) carotid angiography showing that the stenosis improved from >99% to <70% after angioplasty. (C) CTP scans in the resting state showing that CBF, CBV, MTT and TTP in the right cerebral hemisphere are significantly improved, after angioplasty. CTP, CT perfusion; CBF, cerebral blood flow; CBV, cerebral blood volume; ICA, internal carotid artery; MTT, mean transit time; TTP, time to peak.
- Figure 3
Images obtained from a 56-year-old man who manifested with transient right hemiparesis due to cerebral hypoperfusion caused by near occlusion of carotid artery. (A) Carotid angiography performed just before the stage 2 procedure shows remaining stenosis of the ICA, but there is no delayed filling of the distal part of the artery. (B) Carotid angiography performed after the procedure shows that the ICA stenosis is completely dilated after balloon angioplasty and stent placement. (C) After stage 2 angioplasty shows further CBF improvement in the right cerebral hemisphere, but not hyperperfusion. CBF, cerebral blood flow; ICA, internal carotid artery.
Tables
- Table 1
Baseline characteristics of the 44 patients
Age-years Median 67.4 IQR 49–79 Male sex, n (%) 34 (77.2) Stenosis ≥90%, n (%) 27 (61.3) Contralateral stenosis, n (%) ≥50 7 (15.9) ≥60 7 (15.9) ≥70 3 (7) ≥80 5 (11.4) ≥90 0 Occlusion, n (%) 2 (5) CTP Hypoperfusion, n (%) 21 (47.7) Normal, n (%) 23 (52.3) Clinical presentation Amaurosis fugax, n (%) 2 (5) Transient ischaemic attack, n (%) 23 (52.3) Ischaemic stroke, n (%) 9 (20.5) Risk factors Hypertension, n (%) 21 (47.7) Diabetes mellitus, n (%) 14 (31.8) Coronary artery diseases, n (%) 5 (11.4) Smoking, n (%) 6 (13.6) Alcohol use, n (%) 9 (20.4) Circle of Wills Normal 27 (61.4) Variation 17 (38.6) CTP, CT perfusion.
- Table 2
The CTP parameters of patients with carotid artery stenosis regarding as high risk of hyperperfusion pre-pro procedure (n=41)
Preoperation After stage 1 After stage 2 P1 P2 CBF 0.85±0.05 0.98±0.06 1.01±0.07 <0.001 <0.001 CBV 0.98±0.02 0.993±0.022 0.990±0.021 0.70 0.85 MTT 1.15±0.05 1.05±0.05 1.01±0.05 <0.001 <0.001 TTP 1.20±0.06 1.04±0.06 0.99±0.06 <0.001 <0.001 Values are in mean (SD). Numbers in parentheses are the median and range.
CBF, cerebral blood flow; CBV, cerebral blood volume; CTP, CT perfusion; MTT, mean transit time; P1, preoperation compared with stage 1; P2, stage 1 compared with stage 2; TTP, time to peak.
- Table 3
The TCD of patients with carotid artery stenosis regarded as having high risk of hyperperfusion preprocedure (n=41)
Stage 1 Stage 2 TCD 44.44±6.43 66.41±7.41 66.41±7.41 93.78±18.81 p Value <0.001 <0.001 TCD, transcranial Doppler.
