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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

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Cerebral arterial compliance in patients with internal carotid artery disease

E Carrera1, D-J Kim, G Castellani

  • 1Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK. emmanuel.carrera@chuv.ch

European Journal of Neurology
|November 9, 2010
PubMed

Insights

Cerebral arterial compliance (Ca) decreases with internal carotid artery stenosis severity. This study monitored Ca in patients with carotid artery disease, finding reduced Ca reactivity during hypocapnia on the diseased side.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Biomedical Engineering

Background:

  • Decreased internal carotid artery compliance is linked to ischemic stroke risk.
  • No validated techniques exist to monitor intracerebral arterial compliance (Ca) in carotid artery disease patients.
  • This study aimed to monitor Ca in patients with unilateral symptomatic carotid artery disease and assess its response to PaCO2 changes.

Purpose of the Study:

  • To monitor cerebral arterial compliance (Ca) in patients with unilateral symptomatic internal carotid artery stenosis.
  • To determine variations in Ca during changes in partial pressure of carbon dioxide (PaCO2).

Main Methods:

  • 18 patients with >50% unilateral symptomatic internal carotid artery stenosis or occlusion were studied.
  • Arterial blood pressure (ABP) and middle cerebral artery cerebral blood flow velocities (CBFV) were monitored during baseline, hyperventilation, and 5% CO2 inhalation.
  • Cerebral arterial compliance (Ca) was calculated using a novel mathematical model based on ABP and CBFV waveforms.

Main Results:

  • Baseline Ca on the diseased side correlated with stenosis severity (r = -0.35; P = 0.01).
  • During hypocapnia, Ca decreased on both normal and diseased sides (P = 0.004, P = 0.04, respectively).
  • Cerebral arterial compliance reactivity was lower on the diseased side during hypocapnia (3.4% vs. 2.6%; P = 0.04).

Conclusions:

  • Reduced cerebral arterial compliance on the side of stenosis/occlusion correlates with internal carotid artery disease severity.
  • Further research is needed to evaluate if Ca can enhance ischemic event prediction in symptomatic and asymptomatic patients.
Abstract

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