Document Detail

Collateral flow changes through the anterior communicating artery during carotid endarterectomy.
MedLine Citation:
PMID:  8791239     Owner:  NLM     Status:  MEDLINE    
To evaluate early changes in collateral flow through the anterior communicating artery, 11 patients undergoing carotid endarterectomy were monitored. All had angiographically demonstrated collateral flow towards the hemisphere on the side of surgery. The middle cerebral artery ipsilateral to the operated side and the contralateral anterior cerebral artery were simultaneously insonated with a transcranial Doppler instrument equipped with dual transducers, and flow velocity values were obtained at specific surgical stages. Mean flow velocity in the contralateral anterior cerebral artery's A1 segment increased at clamp placement (p = 0.036), did not change during clamping, and decreased at clamp release (p = 0.004). The rise in velocity occurred within seconds of clamp placement in all patients with an increase, reaching the 10 cm/s threshold within 1 min. No consistent increase was detected after 5 min. A decrease in pulsatility index, indicating a drop in resistance, was detected at clamp placement in the middle cerebral artery on the side of surgery (p = 0.012). The index did not change during clamping, but increased at clamp release (p = 0.002). Our findings indicate that significant changes in anterior communicating artery collateral flow occur during carotid endarterectomy, starting within seconds of carotid artery clamping. These changes are associated with arterial resistance alterations in the territory of the middle cerebral artery on the endarterectomy side. Our observations should be useful to assess intracranial early collateral flow changes in surgical and non-surgical settings.
V L Babikian; J J Schwarze; N L Cantelmo; V Pochay; M Winter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  138     ISSN:  0022-510X     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-12-03     Completed Date:  1996-12-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
Department of Neurology, Boston University School of Medicine, MA, USA.
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MeSH Terms
Blood Flow Velocity
Cerebral Arteries / radiography*
Cerebrovascular Circulation / physiology*
Collateral Circulation / physiology*
Endarterectomy, Carotid*
Middle Aged

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