Early haemodynamic changes in the ophthalmic artery, siphon and intracranial arteries after carotid endarterectomy estimated by transcranial Doppler and duplex scanning.

OBJECTIVES

To study early haemodynamic changes in connection with carotid endarterectomy (CE).

METHODS

Sixty-three consecutive patients, average age 64, with symptomatic stenosis in the internal carotid artery (ICA) > or = 70% were examined clinically and by transcranial Doppler (TCD) 1 day before and within 48 h after CE. Duplex scanning of extracranial vessels was performed within 1 week after CE.

RESULTS

After CE, all retrograde systolic velocities (SV) in the ophthalmic artery (OA) and 9/10 retrograde mean velocities (MV) in the siphon changed to antegrade. Antegrade SV in the OA increased significantly (p < 0.001) only on the operated side. SV in the OA on the operated side correlated (p < 0.05) with MV in the siphon, and pulsatility index (PI) in the middle cerebral artery (MCA, p < 0.001). MV in the MCA increased from 46 +/- 12 cm/s to 59 +/- 21 cm/s after CE and in the ACA with normal flow from 54 +/- 19 cm/s to 62 +/- 28 cm/s (p < 0.001 and < 0.05, respectively) only on the operated side. Stump pressure correlated (p < 0.01) with SV in the OA and PI in the MCA and was higher (59 +/- 16 mmHg, p < 0.01) in the group with antegrade flow in the OA compared to the group with retrograde flow in the OA (43 +/- 15 mmHg).

CONCLUSION

TCD and duplex gives important early information about patency of the ICA and haemodynamic intracranial changes after CE.