Short- and long-term hemodynamic and clinical effects of carotid artery stenting

BACKGROUND AND PURPOSE: Stenosis of the carotid artery may cause reduced hemodynamic and neural function that may be ameliorated with CAS. The goal of this study was to evaluate short- and long-term hemodynamic and clinical effects after CAS. MATERIALS AND METHODS: Hemodynamic parameters were acquired by PCT within 1 week before CAS and at 1 week and 1 year (10-13 months) after CAS. In ACA territory, MCA territory, PCA territory, basal ganglia, anterior and posterior CWS and IWS, the rCBF, rCBV, and rMTT were determined in 20 patients with unilateral carotid artery stenosis who underwent CAS. MR and noncontrast CT were performed within 1 week before CAS. Noncontrast CT and carotid arteriography were performed immediately after CAS. Carotid arteriography was performed 1 year after CAS. MRS was performed in 3 measurements. The variance analysis was performed to determine whether there were significant differences among the 3 measurements. RESULTS: No significant differences were found among rCBV in any territory (P > .05). In the non- PCA territories, rMTT decreased and rCBF increased at 1 week after CAS (P < .01), but there was no significant difference between 1-week and 1-year effects (P > .05). For MR spectroscopy, no significant differences were found between 1 week after CAS and pretreatment (P > .05); the 1-year scores improved significantly (P < .01). CONCLUSIONS: The long-term hemodynamic and clinical results after treatment validated that CAS is a durable procedure. The 1-week hemodynamic effects can predict long-term effects.