Journal «Angiology and Vascular Surgery» • 

2000 • VOLUME 6 • №4

DIAGNOSTIC IMAGING FOR FUNCTIONAL ASSESSMENT OF CEREBRAL CIRCULATION IN PATIENTS WITH CAROTID ARTERY ATHEROSCLEROSIS

Yu.B. Lishmanov, I.Yu. Shvera, I.N. Vorozhtsova

The aim of the study was to evaluate the role of diagnostic imaging combined with transesophageal atrial pacing (TEAP) in functional assessment of cerebral circulation in patients with carotid arteriosclerosis before and after carotid endarterectomy (CE). The study included 25 men aged from 48 to 60 with unilateral stenosis (for 55-90%) of internal carotid artery (ICA). Eighteen patients underwent CE. All patients at rest and threshold heart rate during TEAP were examined by means of echocardiography, ICA Doppler sonography, and dynamic radionuclide encephaloangioscintigraphy (DREAS). The same investigation was repeated 3 weeks after CE. Results demonstrated that noninvasive diagnostic imaging, in particular carotid sonography and DREAS of cerebral vessels in combination with TEAP enabled early diagnosis of functional cerebrovascular disorders in stenotic atherosclerosis of brachiocephalic trunk, as well as to assess the efficiency of surgical procedure. The increase in interhemispheric asymmetry of DREAS parameters during TEAP test and aggravation of blood flow asymmetry in major cerebral vessels according to Doppler sonography appeared to be hallmarks of hemodynamically pronounced extracranial vascular stenosis. CE significantly diminishes the severity of functional cerebrovascular disorders in patients with stenotic carotid atherosclerosis.

KEY WORDS: cerebral circulation, carotid atherosclerosis, dynamic radionuclide encephaloangiography, Doppler sonography, carotid endarterectomy.

P. 34

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