cerebral blood flow before and after carotid arteries reconstruction

Defended Nov 17, 1997 in St-Petersburg medical university.

positions protected

• Internal carotid artery stenosis leads to significant changes of brain blood flow not only in both carotid regions but in vertebrobasilar region too.
• Carotid endarterectomy leads to cerebral blood flow improvement in all vascular regions, including both regions of posterior cerebral arteries.
• Transcranial dopplerography is noninvasive and high informative diagnostic method, allowing complex evaluation cerebral blood flow in cases of internal carotid artery stenosis, reveal the presence of vertebrobasilar region robbery

scientific novelty

• Determined cerebral blood flow status in all cerebral vascular regions in internal carotid artery stenosis. Revealed blood flow changes in posterior cerebral artery region, which appear at the development of carotid artery stenosis.
• Studied cerebral blood flow in early and removed periods after carotid artery reconstruction and process of hemodynamics in posterior cerebral artery recovery in early and removed postoperative periods.

conclusions

1. Internal cerebral artery occlusion leads to blood flow breaches not only in both carotid regions, but in vertebrobasilar region too.
2. Index of reactivity asymmetry offered allows to produce a reliable numerical evaluation of reactivity breaking in all cerebrovascular regions.
3. Monolateral carotid endarterectomy promotes cerebral blood flow improvement in both carotid, as well as vertebrobasilar regions.
4. Significant brain hemodynamics improvement in vertebrobasilar region in patients with transitory cerebral circulation impairment and in the group with asymptomatic disease development shows the presence of surgical indications when carotid stenosis is found.