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The importance of blood flow volume in the brain-supplying arteries for the clinical management – the impact of collateral circulation

Michał Elwertowski
Michał Elwertowski
, 
Jerzy Leszczyński
Jerzy Leszczyński
, 
Piotr Kaszczewski
Piotr Kaszczewski
, 
Krzysztof Lamparski
Krzysztof Lamparski
, 
Stella Sin Yee Ho
Stella Sin Yee Ho
 et 
Zbigniew Gałązka
Zbigniew Gałązka
   | 31 août 2018
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Article Category: original-paper
Publié en ligne: 31 août 2018
Pages: 112 - 119
Reçu: 03 janv. 2018
Accepté: 29 juin 2018
DOI: https://doi.org/10.15557/jou.2018.0016
Mots clés
© 2018 Michał Elwertowski et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Increased compensatory blood flow: A. RICA obstruction; B. RECA with increased blood flow 183 mL/min; C. RVA blood flow of 76 mL/min (normal); D. LICA with flat atherosclerotic lesions; E. LICA increased compensatory blood flow 537 mL/min; F. LECA increased blood flow 174 mL/min; G. LVA increased blood flow 183 mL/min. Total blood flow 1153 mL/min despite obstruction
Increased compensatory blood flow: A. RICA obstruction; B. RECA with increased blood flow 183 mL/min; C. RVA blood flow of 76 mL/min (normal); D. LICA with flat atherosclerotic lesions; E. LICA increased compensatory blood flow 537 mL/min; F. LECA increased blood flow 174 mL/min; G. LVA increased blood flow 183 mL/min. Total blood flow 1153 mL/min despite obstruction

Fig. 2.

Uncompensated, asymptomatic RICA stenosis: A. Morphology; B. Spectral recording of PSV 425 cm/s, EDV 85 cm/s; C. Reduced RICA blood flow 140 mL/min; D. RECA blood flow 81 mL/min (normal); E. RVA blood flow 79 mL/min (normal); F. L ICA with flat atherosclerotic lesions; G. Decreased LICA blood flow 153 mL/min; H. LECA blood flow 143 mL/min (upper limit of normal); I. LVA blood flow 90 mL/min (normal). Significantly decreased total blood flow 686 mL/min, the patient is a candidate for interventional treatment
Uncompensated, asymptomatic RICA stenosis: A. Morphology; B. Spectral recording of PSV 425 cm/s, EDV 85 cm/s; C. Reduced RICA blood flow 140 mL/min; D. RECA blood flow 81 mL/min (normal); E. RVA blood flow 79 mL/min (normal); F. L ICA with flat atherosclerotic lesions; G. Decreased LICA blood flow 153 mL/min; H. LECA blood flow 143 mL/min (upper limit of normal); I. LVA blood flow 90 mL/min (normal). Significantly decreased total blood flow 686 mL/min, the patient is a candidate for interventional treatment

Fig. 3.

Compensated, asymptomatic RICA stenosis: A. stenosis morphology, about 90–95%; B. Decreased RICA blood flow 28 mL/min; C. RECA blood flow 104 mL/min (normal); D. RVA with compensatory blood flow increase 258 mL/min; E. LICA with no atherosclerotic lesions; F. LICA increased compensatory blood flow 657 mL/min; G. LECA blood flow 104 mL/min (normal); H. LVA blood flow 110 mL/min (normal). Total blood flow 1261 mL/min – the patient requires no intervention, a candidate for conservative treatment
Compensated, asymptomatic RICA stenosis: A. stenosis morphology, about 90–95%; B. Decreased RICA blood flow 28 mL/min; C. RECA blood flow 104 mL/min (normal); D. RVA with compensatory blood flow increase 258 mL/min; E. LICA with no atherosclerotic lesions; F. LICA increased compensatory blood flow 657 mL/min; G. LECA blood flow 104 mL/min (normal); H. LVA blood flow 110 mL/min (normal). Total blood flow 1261 mL/min – the patient requires no intervention, a candidate for conservative treatment

Patient classification

  No. Mean age
Controls group 94 63.9
Asymptomatic patients – stenosis up to 40% 30 69.5
Patients after endarterectomy 12 68.5
Stenosis without blood flow compensation 38 70.7
Stenosis with blood flow compensation 44 66.1

Blood flow volume, mean velocity, mean percentage stenosis and total blood flow in the brain-supplying arteries in different groups of patients

Przepływ Blood flow n = 94 Asymptomatic n = 30 Post-surgical EA n = 12 Stenosis with no compensation n = 38 Stenosis with compensation n = 44
R ICA mL/min 285 234 319 222 239
R ECA mL/min 127 132 97 115 179
R VA mL/min 71 68 83 98 137
L ICA mL/min 295 270 231 208 333
L ECA mL/min 122 126 134 115 156
L VA mL/min 92 98 107 95 141
R ICA velocity cm/s 73/24 103/28 115/35 159/42 126/42
L ICA velocity cm/s 70/24 84/24 162/44 132/37 144/44
R ICA stenosis % 0 28 18 51 55
L ICA stenosis % 0 22 44 48 45
Total blond flow mL/min 985 920 960 844 1174
eISSN:
2451-070X
Langue:
Anglais
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4 fois par an
Sujets de la revue:
Medicine, Basic Medical Science, other
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