Publikation:

Bilateral severe carotid artery stenosis or occlusion : cerebral autoregulation dynamics and collateral flow patterns

Lade...
Vorschaubild

Dateien

Reinhard_272497.pdf
Reinhard_272497.pdfGröße: 849.68 KBDownloads: 490

Datum

2003

Autor:innen

Reinhard, Matthias
Roth, Markus
Guschlbauer, Brigitte
Timmer, Jens
Hetzel, Andreas

Herausgeber:innen

Kontakt

ISSN der Zeitschrift

Electronic ISSN

ISBN

Bibliografische Daten

Verlag

Schriftenreihe

Auflagebezeichnung

ArXiv-ID

Internationale Patentnummer

Angaben zur Forschungsförderung

Projekt

Open Access-Veröffentlichung
Open Access Green
Core Facility der Universität Konstanz

Gesperrt bis

Titel in einer weiteren Sprache

Publikationstyp
Zeitschriftenartikel
Publikationsstatus
Published

Erschienen in

Acta Neurochirurgica. 2003, 145(12), pp. 1053-1060. ISSN 0001-6268. eISSN 0942-0940. Available under: doi: 10.1007/s00701-003-0137-8

Zusammenfassung

Background

Bilateral severe obstruction of the internal carotid artery is a hemodynamically critical state. We aimed to (1) analyze dynamic cerebral autoregulation (DCA) in affected patients, and (2) to correlate DCA data with different collateral flow patterns.


Methods

DCA was assessed noninvasively by transfer function analysis (phase shift) of respiratory-induced oscillations at 0.1 Hz of arterial blood pressure (Finapres method) and cerebral blood flow velocity (transcranial Doppler) in 30 patients with severe bilateral carotid stenosis (> or =75%) or occlusion. CO(2)-reactivity was measured via inhalation of 7% CO(2). 30 patients with unilateral stenosis were recruited as controls.


Results

Patients with bilateral 75-89% stenosis had a virtually preserved phase shift. A pronounced reduction was found in bilateral critical stenosis or obstruction (90-100%). Patients with ipsilateral 90-100% and contralateral 75-89% stenosis had a significantly less severe reduction of phase shift on the ipsilateral side. CO(2)-reactivity showed a less marked reduction in patients with bilateral critical stenosis or occlusion. Phase shift was best if "Willisian" collaterals were present. Significantly reduced values were found if only secondary collaterals (ophthalmic artery, leptomeningeal flow) were detected. Poorest values occurred with recruitment of functionally stenosed "Willisian" collaterals. CO(2)-reactivity showed poor values with sole recruitment of secondary collaterals, whereas functionally stenosed primary collaterals did not show values as poor as for phase shift. Clinically symptomatic patients had significantly lower phase shift and CO(2)-reactivity values.


Conclusions

DCA is severely impaired in bilateral critical carotid stenosis or occlusion. Sole recruitment of secondary collaterals and signs of a functional stenosis in primary ("Willisian") collaterals reflect insufficient collateral supply with a poor hemodynamic status. CO(2)-reactivity assessing the vasodilatory reserve and DCA represent different information for characterizing cerebral hemodynamic impairment. Determining transfer function phase might be a physiologically well supported approach for analysis of cerebral hemodynamic compromise.

Zusammenfassung in einer weiteren Sprache

Fachgebiet (DDC)
100 Philosophie

Schlagwörter

Aged, Blood Flow Velocity, Blood Pressure, Brain, Carbon Dioxide, Carotid Stenosis, Cerebral Arteries, Cerebral Infarction, Circle of Willis, Collateral Circulation, Dominance, Cerebral, Female, Fourier Analysis, Homeostasis, Humans, Ischemic Attack, Transient, Male, Middle Aged, Oscillometry, Pulsatile Flow, Recurrence, Risk Assessment, Ultrasonography, Doppler, Transcranial, Vascular Resistance

Konferenz

Rezension
undefined / . - undefined, undefined

Forschungsvorhaben

Organisationseinheiten

Zeitschriftenheft

Zugehörige Datensätze in KOPS

Zitieren

ISO 690REINHARD, Matthias, Thomas MÜLLER, Markus ROTH, Brigitte GUSCHLBAUER, Jens TIMMER, Andreas HETZEL, 2003. Bilateral severe carotid artery stenosis or occlusion : cerebral autoregulation dynamics and collateral flow patterns. In: Acta Neurochirurgica. 2003, 145(12), pp. 1053-1060. ISSN 0001-6268. eISSN 0942-0940. Available under: doi: 10.1007/s00701-003-0137-8
BibTex
@article{Reinhard2003-12Bilat-27249,
  year={2003},
  doi={10.1007/s00701-003-0137-8},
  title={Bilateral severe carotid artery stenosis or occlusion : cerebral autoregulation dynamics and collateral flow patterns},
  number={12},
  volume={145},
  issn={0001-6268},
  journal={Acta Neurochirurgica},
  pages={1053--1060},
  author={Reinhard, Matthias and Müller, Thomas and Roth, Markus and Guschlbauer, Brigitte and Timmer, Jens and Hetzel, Andreas}
}
RDF
<rdf:RDF
    xmlns:dcterms="http://purl.org/dc/terms/"
    xmlns:dc="http://purl.org/dc/elements/1.1/"
    xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
    xmlns:bibo="http://purl.org/ontology/bibo/"
    xmlns:dspace="http://digital-repositories.org/ontologies/dspace/0.1.0#"
    xmlns:foaf="http://xmlns.com/foaf/0.1/"
    xmlns:void="http://rdfs.org/ns/void#"
    xmlns:xsd="http://www.w3.org/2001/XMLSchema#" > 
  <rdf:Description rdf:about="https://kops.uni-konstanz.de/server/rdf/resource/123456789/27249">
    <dspace:hasBitstream rdf:resource="https://kops.uni-konstanz.de/bitstream/123456789/27249/2/Reinhard_272497.pdf"/>
    <dc:contributor>Müller, Thomas</dc:contributor>
    <dc:contributor>Guschlbauer, Brigitte</dc:contributor>
    <dc:contributor>Hetzel, Andreas</dc:contributor>
    <dc:date rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2014-04-07T08:17:46Z</dc:date>
    <void:sparqlEndpoint rdf:resource="http://localhost/fuseki/dspace/sparql"/>
    <dcterms:isPartOf rdf:resource="https://kops.uni-konstanz.de/server/rdf/resource/123456789/40"/>
    <dcterms:title>Bilateral severe carotid artery stenosis or occlusion : cerebral autoregulation dynamics and collateral flow patterns</dcterms:title>
    <dcterms:issued>2003-12</dcterms:issued>
    <bibo:uri rdf:resource="http://kops.uni-konstanz.de/handle/123456789/27249"/>
    <dc:contributor>Roth, Markus</dc:contributor>
    <foaf:homepage rdf:resource="http://localhost:8080/"/>
    <dc:creator>Reinhard, Matthias</dc:creator>
    <dc:contributor>Timmer, Jens</dc:contributor>
    <dc:creator>Müller, Thomas</dc:creator>
    <dc:language>eng</dc:language>
    <dc:rights>terms-of-use</dc:rights>
    <dcterms:available rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2014-04-07T08:17:46Z</dcterms:available>
    <dcterms:rights rdf:resource="https://rightsstatements.org/page/InC/1.0/"/>
    <dc:creator>Timmer, Jens</dc:creator>
    <dc:creator>Hetzel, Andreas</dc:creator>
    <dc:creator>Roth, Markus</dc:creator>
    <dcterms:hasPart rdf:resource="https://kops.uni-konstanz.de/bitstream/123456789/27249/2/Reinhard_272497.pdf"/>
    <dspace:isPartOfCollection rdf:resource="https://kops.uni-konstanz.de/server/rdf/resource/123456789/40"/>
    <dcterms:bibliographicCitation>Acta Neurochirurgica ; 145 (2003), 12. - S. 1053-1060</dcterms:bibliographicCitation>
    <dc:contributor>Reinhard, Matthias</dc:contributor>
    <dcterms:abstract xml:lang="eng">Background&lt;br /&gt;&lt;br /&gt;Bilateral severe obstruction of the internal carotid artery is a hemodynamically critical state. We aimed to (1) analyze dynamic cerebral autoregulation (DCA) in affected patients, and (2) to correlate DCA data with different collateral flow patterns.&lt;br /&gt;&lt;br /&gt;&lt;br /&gt;Methods&lt;br /&gt;&lt;br /&gt;DCA was assessed noninvasively by transfer function analysis (phase shift) of respiratory-induced oscillations at 0.1 Hz of arterial blood pressure (Finapres method) and cerebral blood flow velocity (transcranial Doppler) in 30 patients with severe bilateral carotid stenosis (&gt; or =75%) or occlusion. CO(2)-reactivity was measured via inhalation of 7% CO(2). 30 patients with unilateral stenosis were recruited as controls.&lt;br /&gt;&lt;br /&gt;&lt;br /&gt;Results&lt;br /&gt;&lt;br /&gt;Patients with bilateral 75-89% stenosis had a virtually preserved phase shift. A pronounced reduction was found in bilateral critical stenosis or obstruction (90-100%). Patients with ipsilateral 90-100% and contralateral 75-89% stenosis had a significantly less severe reduction of phase shift on the ipsilateral side. CO(2)-reactivity showed a less marked reduction in patients with bilateral critical stenosis or occlusion. Phase shift was best if "Willisian" collaterals were present. Significantly reduced values were found if only secondary collaterals (ophthalmic artery, leptomeningeal flow) were detected. Poorest values occurred with recruitment of functionally stenosed "Willisian" collaterals. CO(2)-reactivity showed poor values with sole recruitment of secondary collaterals, whereas functionally stenosed primary collaterals did not show values as poor as for phase shift. Clinically symptomatic patients had significantly lower phase shift and CO(2)-reactivity values.&lt;br /&gt;&lt;br /&gt;&lt;br /&gt;Conclusions&lt;br /&gt;&lt;br /&gt;DCA is severely impaired in bilateral critical carotid stenosis or occlusion. Sole recruitment of secondary collaterals and signs of a functional stenosis in primary ("Willisian") collaterals reflect insufficient collateral supply with a poor hemodynamic status. CO(2)-reactivity assessing the vasodilatory reserve and DCA represent different information for characterizing cerebral hemodynamic impairment. Determining transfer function phase might be a physiologically well supported approach for analysis of cerebral hemodynamic compromise.</dcterms:abstract>
    <dc:creator>Guschlbauer, Brigitte</dc:creator>
  </rdf:Description>
</rdf:RDF>

Interner Vermerk

xmlui.Submission.submit.DescribeStep.inputForms.label.kops_note_fromSubmitter

Kontakt
URL der Originalveröffentl.

Prüfdatum der URL

Prüfungsdatum der Dissertation

Finanzierungsart

Kommentar zur Publikation

Allianzlizenz
Corresponding Authors der Uni Konstanz vorhanden
Internationale Co-Autor:innen
Universitätsbibliographie
Nein
Begutachtet
Diese Publikation teilen