Gait improvement after carotid endarterectomy
1Second Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Summary
Carotid endarterectomy significantly improved gait disturbance in patients with internal carotid artery flow lesions. Enhanced cerebral circulation and perfusion post-surgery correlated with better gait analysis outcomes.
Area of Science:
- Neurology
- Vascular Surgery
- Medical Imaging
Background:
- Gait disturbance can result from cerebral ischemia due to internal carotid artery (ICA) flow lesions.
- Carotid endarterectomy (CEA) aims to restore blood flow, but its impact on gait and cerebral circulation requires detailed investigation.
Purpose of the Study:
- To investigate the effects of carotid endarterectomy on cerebral circulation and gait in patients with ICA flow lesions and gait disturbance.
- To correlate changes in cerebral blood flow and perfusion with gait improvement after CEA.
Main Methods:
- Prospective study involving 16 patients with gait disturbance due to ICA flow lesions.
- Pre- and post-operative gait analysis, duplex sonography for volume flow, single-photon emission computed tomography (SPECT) for cerebral perfusion (CP), and angiograms (cerebral or MR) for collateral circulation assessment.
Main Results:
- 14 out of 16 patients (87.5%) showed significant gait improvement post-CEA.
- Improvements were statistically significant in cadence, speed, stride length, step time, and knee range of motion (P<0.05).
- Dramatic gait improvement was observed in 8 patients with increased Doppler volume flow, 7 of whom had increased CP (SPECT) and an incomplete circle of Willis.
Conclusions:
- Carotid endarterectomy is effective in improving gait disturbance associated with ICA flow lesions.
- Significant gait improvement is most pronounced in patients with severely reduced preoperative flow, incomplete circle of Willis, and markedly increased postoperative cerebral perfusion.
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