TY - JOUR T1 - Absence of the Anterior Communicating Artery on Selective MRA is Associated with New Ischemic Lesions on MRI after Carotid Revascularization JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1124 LP - 1130 DO - 10.3174/ajnr.A7570 VL - 43 IS - 8 AU - S. Yamashita AU - M. Kohta AU - K. Hosoda AU - J. Tanaka AU - K. Matsuo AU - H. Kimura AU - K. Tanaka AU - A. Fujita AU - T. Sasayama Y1 - 2022/08/01 UR - http://www.ajnr.org/content/43/8/1124.abstract N2 - BACKGROUND AND PURPOSE: ICA-selective MRA using a pencil beam presaturation pulse can accurately visualize anterior communicating artery flow. We evaluated the impact of anterior communicating artery flow on the perioperative hemodynamic status and new ischemic lesions after carotid revascularization.MATERIALS AND METHODS: Eighty-three patients with carotid artery stenosis were included. We assessed anterior communicating artery flow using ICA-selective MRA. The preoperative hemodynamic status was measured using SPECT. We also measured the change in regional cerebral oxygen saturation after temporary ICA occlusion. New ischemic lesions were evaluated by DWI on the day after treatment.RESULTS: Anterior communicating artery flow was detected in 61 patients, but it was not detected in 22 patients. Preoperative cerebrovascular reactivity was significantly higher in patients with (versus without) anterior communicating artery flow with a mean peak systolic velocity of ≥200 cm/s (39.6% [SD, 23.8%] versus 25.2% [SD, 16.4%]; P = .030). The decrease in mean regional cerebral oxygen saturation was significantly greater in patients without (versus with) anterior communicating artery flow (8.5% [SD, 5.6%] versus 3.7% [SD, 3.8%]; P = .002). New ischemic lesions after the procedure were observed in 23 patients. The multivariate logistic regression analysis revealed that anterior communicating artery flow (OR, 0.07; 95% CI, 0.012–0.45; P = .005) was associated with new ischemic lesions.CONCLUSIONS: The absence of anterior communicating artery flow influenced the perioperative hemodynamic status in patients with carotid stenosis and was associated with an increased incidence of new ischemic lesions after carotid revascularization.AcomAanterior communicating arteryBeamSATpencil beam presaturationCAScarotid artery stentingCEAcarotid endarterectomyCVRcerebrovascular reactivityPSVpeak systolic velocityrSO2regional cerebral oxygen saturation ER -