Demystifying changes in cerebral blood flow after CEA

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Demystifying changes in cerebral blood flow after CEA

2022-01-28 12:05:29 30 ℃

Using a 4D (4D) bloodstream (FLOW) magnetic resonance imaging (MRI), we proposed a comprehensive, non-invasive approach to evaluating cerebral fluidity before and after carotidity.

- Excerpt from the article chapter

[REF: J VASC SURG 2021 Sep; 74 (3): 910-920.E1. Doi: 10.1016 / j.jvs.2021.01.074. EPUB 2021 Mar 31.】

A commentator

We evaluate the fundamental hypothesis of the treatment significance of carotid intimal resection (CEA) to the patient, which is the main cause of cerebral ischemic incidents in patients with symptoms of carotid and plaque, which predicts of. However, the degree of carotid stenosis does not provide complete information about its influence on cerebral blood flow and hemodynamics. Therefore, the change in intracranial blood dynamics before and after carotid vessels will further improve our understanding of pathophysiology and surgical risks and benefits of stroke. 4D Flow-MRI uses to provide us with new ways of catalytic blood flow mechanics and pathophysical changes in patients with intimae resection, and is expected to develop a powerful tool for predicting postoperative effects of patients.

Research Background

Cervical stenosis will deeply affect cerebral blood flow, but the specific relationship between stenosis and cerebral isprint is unclear. We quantify and males the cerebral pulse flow rate (BFR) distribution before and after carotid endometrial resection using four-dimensional (4D) blood flow (MRI).

Research methods

19 Symptoms (≥50%) patients undergoing carotid intimal resection (CEA) patients (age, 71 ± 6 years old; 2 women) were tested using 4D Flow-MRI after surgery and postoperative . We measured the BFR of 17 cereal artery and eye artery. The recruitment of the lateral branch of the mean artery before, afterwards were quantified. The lateralness of the BFR is significantly different between the pair of opposite arteries and the same side artery. We define subgroups depending on the existing sideset set.

Research result

After CEA, the cerebral blood flow in the overall patient increased by 15% (P <.01). Before CEA, the internal artery, brain anterior artery and brain artery (MCA) have a lateral change. At the same side, the Cea-neck artery was found after CEA (246 ± 62 mL / min vs 135 ± 80 mL / min;

Table 1: Clinical and vascular characteristics of the group patients.

Table 2: The average blood flow rate of the individual brain artery.

Figure 1: On and after the co-side (C) of the on-side (C), the relative distribution of the total cerebral blood flow (TCBF) of each cerebral artery (6 standard deviations) .

Figure 2: Case (b) before (a) and after CEA) before (a) and after CEA, the same side (i) and the opposite side (C) are shown by the rear traffic artery (PCOA) The relative distribution of total cerebral blood flow (TCBF) of each cerebral artery.

Figure 3: Cerebral film side support for carotid endometriosis (CEA) The relative distribution of blood flow (TCBF).

Figure 4: This case is given to the front and rear supply of the former transportation artery (ACOA) before and after the carotid intimal resection (CEA). The relative distribution of the total cerebral blood flow (TCBF) of the same side (i) and the opposite side (c) individual cerebral artery.

Figure 5: A subgroup analysis established by the cerebral artery (MCA) in the carotid intimal resection (CEA).

Analysis conclusion

Using 4D Flow-MRI, we proposed a comprehensive, non-invasive approach to assessing cerebral blood movement before and after cervical stenosis. The MCA side branch as seen in patients with side branches in CEA, suggests blood flow kinetic barriers in these patient MCA regions. The advancement of this approach has made people's pathological physiology of cerebral fluid mechanics in patients with carotid artery.

Agencies and group disciplines: Beijing Friendship Hospital, Capital Medical University, Department of Vascular Surgery, Liu Mingyuan, attending physician

Edit: Vascular News Oliver