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Hemodynamic effects of innominate artery occlusive disease on anterior cerebral artery

Teng-Yeow Tan1, Li-Ming Lien, Ulf Schminke

  • 1Department of Neurology, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan. tengyeowtan@yahoo.com

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|February 6, 2002
PubMed

Insights

Innominate artery stenosis can rarely cause alternating flow in the anterior cerebral artery. This case highlights the need for combined Doppler and imaging for diagnosing cerebrovascular disease.

Area of Science:

  • Vascular Neurology
  • Cerebrovascular Hemodynamics
  • Diagnostic Imaging

Background:

  • Innominate artery (IA) stenosis can impact cerebral blood flow.
  • Alternating flow in the anterior cerebral artery (ACA) due to IA stenosis is a rare phenomenon.

Observation:

  • A 49-year-old woman presented with symptoms of cerebrovascular disease.
  • She exhibited right subclavian and carotid artery "steal" phenomena.
  • Transcranial Doppler revealed systolic deceleration in the right internal carotid artery and alternating flow in the right ACA.

Findings:

  • Magnetic resonance angiography confirmed severe stenosis of the right innominate artery.
  • The findings suggest a direct hemodynamic consequence of IA stenosis on ACA flow.

Implications:

  • This case underscores the importance of considering IA stenosis in patients with unusual cerebrovascular steal patterns.
  • Combined duplex and transcranial Doppler examinations are crucial for a comprehensive hemodynamic assessment of IA stenosis.
  • Understanding these rare flow dynamics aids in diagnosing and managing complex cerebrovascular conditions.

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