J Vasc Surg: Asymptomatic cervical artery stenosis is associated with insufficient brain perfusion

Nearly 50% of patients with asymptomatic cervical artery stenosis (ACS) exhibit cognitive impairment.
recent evidence suggests that inadequate brain perfusion is an important cause of cognitive impairment.
narrowing of the cervical arteries limits the flow of blood into the brain, leading to inadequate brain perfusion.
, cross-hem by willis ring and cerebrovascular esopenis can also reduce the effects of blood flow restriction.
In this way, vascular surgeons, bioengineering experts, and imaging experts from the United States have worked together to develop a clinically relevant method of measuring net brain perfusion in ACS patients that can help with dangerous stratification and determine treatment methods.
To determine whether ACS causes insufficient brain perfusion, the researchers developed a new way to quantify the differences between brain perfusions in peak time (TTP) and average transmission time (MTT) delays in total brain perfusion-weighted magnetic resonance imaging (PWI).
to assess the usefulness of clinical Doppler ultrasound (DUS) inferred brain perfusion and to assess the relationship between PWI and ultrasonic systolic peak velocity (PSV).
the study was published online November 6, 2020 on the website of the journal Journal ofVascular Surgery.
study examined 70 percent of patients ≥ 20 ACS patients for brain MRI and cervical artery MRA.
PSV for DUS, mrA provides geometric measurements of narrow patches.
analysis of PWI's full brain volume perfusion graph to obtain the average hem difference between TTP and MTT latency.
, the proportion of TTP and MTT delays shown in brain capacity was measured.
these ratios are measured to increase the severity of blood flow delays (0.5, 1.0, and 2.0 seconds).
, PWI perfusion asymmetry is associated with PSV, and DUS narrowness is associated with Pearson correlation coefficients.
18 cases were one-sided stenosis (8 cases on the right and 10 cases on the left) and 2 cases were two-sided stenosis.
16 out of 18 patients with tera-hem (left-right) delay in measuring total brain capacity were found to have damage to the narrow hemisphere perfusion.
more than 45 percent of patients experience istemia in at least half of their brain capacity, with a TTP delay of 0.5 seconds.
TTP and MTT delays are highly relevant to PSV and less relevant to narrow percentages.
PSV has the strongest correlation with whole brain perfusion defects (TTP and MTT delay) (r 0.80 and 0.74, respectively), rather than the results of individual MRA slice measurements in current clinical scenarios (r 0.31 and 0.58, respectively).
that PWI measurement of TTP and MTT delays across the brain provides a new tool for ACS patients to assess brain perfusion defects.
in more than 80% of patients, cervical artery stenosis was associated with a significant decrease in side-by-side brain perfusion compared to side-by-side brain perfusion.
the ultrasound measurement of cervical artery stenosis was associated with TTP and MTT delays and could be used as a clinical alternative to inadequate brain perfusion in these patients.
Key findings are a new method of quantifying brain-wide perfusion defects using perfusion-weighted magnetic resonance imaging, and brain perfusion damage is found in more than 80 percent (≥70%) patients with asymptomatic cervical artery stenosis.
peak rate (PSV) of clinical ultrasonic measurements is closely related to insufficient perfusion (r s 0.81).
increase in the peak velocity of the systolic period in ultrasound is associated with the peak time of MR perfusion scanning and the delay of average transmission time, and can be used as a clinically useful alternative to insufficient brain perfusion in these patients.
, a large number of asymptomatic cervical artery stenosis patients have insufficient cerebral perfusion, and the shrinkage velocity based on Doppler's ultrasound peak can be used as an effective alternative to perfusion status.
quantitative analysis of inadequate brain perfusion may help to layer patients with asymptomatic cervical artery stenosis at risk.
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