Basic Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Feb 28, 2015; 7(2): 45-51
Published online Feb 28, 2015. doi: 10.4329/wjr.v7.i2.45
Evaluation of changes of intracranial blood flow after carotid artery stenting using digital subtraction angiography flow assessment
Hajime Wada, Masato Saito, Kyousuke Kamada
Hajime Wada, Masato Saito, Kyousuke Kamada, Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido 0788510, Japan
Author contributions: All authors contributed to this work.
Ethics approval: The study was reviewed and approved.
Institutional animal care and use committee: This study has been approved by institutional ethical committeee (No. 132).
Conflict-of-interest: The authors report no conflict of interest regarding the manuscpt.
Data sharing: The authors accept the data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kyousuke Kamasda, MD, PhD, Department of Neurosurgery, Asahikawa Medical University, 2-1, 1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan. hjwada@asahikawa-med.ac.jp
Telephone: +81-166-682594 Fax: +81-166-682599
Received: October 28, 2014
Peer-review started: October 29, 2014
First decision: December 12, 2014
Revised: December 25, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: February 28, 2015
Abstract

AIM: To evaluate the changes of intracranial blood flow after carotid artery stenting (CAS), using the flow assessment application “Flow-Insight”, which was developed in our department.

METHODS: Twenty patients treated by CAS participated in this study. We analyzed the change in concentration of the contrast media at the anterior-posterior and profile view image with the flow assessment application “Flow-Insight”. And we compared the results with N-isopropyl-p-[123I] iodoamphetamine-single-photon emission computed tomography (IMP SPECT) performed before and after the treatment.

RESULTS: From this study, 200% of the parameter “blood flow” change in the post/pre-treatment is suggested as the critical line of the hyperperfusion syndrome arise. Although the observed blood flow increase in the digital subtraction angiography system did not strongly correlate with the rate of increase of SPECT, the “Flow-Insight” reflected the rate of change of the vessels well. However, for patients with reduced reserve blood flow before CAS, a highly elevated site was in agreement with the site analysis results.

CONCLUSION: We concluded that the cerebral angiography flow assessment application was able to more finely reveal hyperperfusion regions in the brain after CAS compared to SPECT.

Keywords: Intracranial blood flow, Cerebral angiography, Carotid artery stenting, Single-photon emission computed tomography

Core tip: Hyperperfusion syndrome is a relatively rare, but potentially serious, complication of carotid revascularization procedures. It is important to detect the excessive increase blood flow after treatment as soon as possible. We found that, although the observed blood flow increase in the digital subtraction angiography system did not strongly correlate with the rate of increase of single-photon emission computed tomography before and after carotid artery stenting, the digital subtraction angiography flow assessment application more finely reflected the rate of change of the vessels well.