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AJNR - American Journal of Neuroradiology

Published ahead of print on February 22, 2008
doi: 10.3174/ajnr.A0945

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American Journal of Neuroradiology 29:919-923, May 2008
© 2008 American Society of Neuroradiology

BRAIN

Sixty-Four-Section CT Cerebral Perfusion Evaluation in Patients with Carotid Artery Stenosis before and after Stenting with a Cerebral Protection Device

F. Gaudiello^a, V. Colangelo^a, F. Bolacchi^a, M. Melis^a, R. Gandini^a, F.G. Garaci^a, V. Cozzolino^a, R. Floris^a and G. Simonetti^a

^a From the Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy

Please address correspondence to Vittorio Colangelo, MD, Viale Oxford 81, 00133 Rome, Italy; e-mail: vcolan{at}tiscali.it

BACKGROUND AND PURPOSE: Brain tissue viability depends on cerebral blood flow (CBF) that has to be kept within a narrow range to avoid the risk of developing ischemia. The aim of the study was to evaluate by 64-section CT (VCT) the cerebral perfusion modifications in patients with severe carotid stenosis before and after undergoing carotid artery stent placement (CAS) with a cerebral protection system.

MATERIALS AND METHODS: Fifteen patients with unilateral internal carotid stenosis (70%) underwent brain perfusional VCT (PVCT) 5 days before and 1 week after the stent-placement procedure. CBF and mean transit time (MTT) values were measured.

RESULTS: Decreased CBF and increased MTT values were observed in the cerebral areas supplied by the stenotic artery as compared with the areas supplied by the contralateral patent artery (P < .001). A significant normalization of the perfusion parameters was observed after the stent-placement procedure (mean pretreatment MTT value, 5.3 ± 0.2; mean posttreatment MTT value, 4.3 ± 0.18, P < .001; mean pretreatment CBF value, 41.2 mL/s ± 2.1; mean posttreatment CBF value, 47.9 mL/s ± 2.9, P < .001).

CONCLUSIONS: PVCT is a useful technique for the assessment of the hemodynamic modifications in patients with severe carotid stenosis. The quantitative evaluation of cerebral perfusion makes it a reliable tool for the follow-up of patients who undergo CAS.