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ASSESSMENT OF CEREBRAL PERFUSION IN PATIENTS WITH HEMODYNAMIC ISCHEMIC STROKE UNDERGOING RECONSTRUCTIVE BRACHIOCEPHALIC ARTERY INTERVENTIONS

https://doi.org/10.20862/0042-4676-2016-97-6-365-372

Abstract

The paper deals with the assessment of cerebral perfusion in patients in the acute period of acute cerebrovascular accident before and after revascularization surgery. It gives a clinical example of using contrast-free perfusion magnetic resonance imaging (MRI) in a patient with hemodynamic ischemic stroke. The use of this technique made it possible to determine indications for early carotid endarterectomy for the contralateral internal carotid artery and to evaluate positive postoperative changes in cerebral perfusion and the patient’s neurological status. The authors analyzed the current literature on this problem with a particular emphasis on the possibilities of using dynamic susceptibility contrast-enhanced and arterial spin-labeling contrast-free perfusion MRI in this category of patients. Carotid endarterectomy in the acute period of acute cerebrovascular accident can improve cerebral hemodynamics and the patient’s neurological status and prevent recurrent cerebral circulatory disorders. Indications for this surgery should be determined by taking into consideration the results of perfusion MRI techniques (single-photon computed tomography contrastenhanced and contrast-free perfusion MRI).

About the Authors

V. A. Luk'yanchikov
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the RF, ul. Dolgorukovskaya, 4, Moscow, 127006, Russian Federation;
Russian Federation
MD, PhD, Head of Neurosurgical Department for the Treatment of Patients with Cerebrovascular Diseases


Yu. I. Shatokhina
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation
Russian Federation
Radiologist


E. V. Udodov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the RF, ul. Dolgorukovskaya, 4, Moscow, 127006, Russian Federation; N.A. Semashko Republican Clinical Hospital, ul. Kievskaya, 69, Simferopol, 295034, Russian Federation
Russian Federation
Neurosurgeon


A. S. Tokarev
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation
Russian Federation
MD, PhD, Head of Department of “Center of Radiosurgery”, Neurosurgeon


N. A. Polunina
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the RF, ul. Dolgorukovskaya, 4, Moscow, 127006, Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Neurosurgeon


N. E. Kudryashova
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation
Russian Federation
MD, PhD, DSc, Head of Department of Radioisotope Diagnostic and Clinical Physiology


V. V. Krylov
N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Bol’shaya Sukharevskaya Ploshchad’, 3, Moscow, 129010, Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the RF, ul. Dolgorukovskaya, 4, Moscow, 127006, Russian Federation;
Russian Federation
MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences


References

1. Гусев Е.И., Коновалов А.Н., Скворцова В.И., Гехт А.Б. (ред.). Неврология: национальное руководство. М.: ГЭОТАР-Медиа; 2010. [Gusev E.I., Konovalov A.N., Skvortsova V.I., Gekht A.B. (eds.). Neurology: national guidance. Moscow: GEOTAR-Media; 2010 (in Russ.).]

2. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998; 351 (9113): 1379–87.

3. Barnett H.J.M. Prospective randomized trial of symptomatic patients: result from the NASCET study. In: Moore W.S. (ed.). Surgery for cerebrovascular disease. Philadelphia: W.B. Saunders; 1996; 74: 537–9.

4. Kasper G.C., Wladis A.R., Lohr J.M., Roedersheimer L.R., Reed R.L., Miller T.J. et al. Carotid thromboendarterectomy for recent total occlusion of the internal carotid artery. J. Vasc. Surg. 2001; 33 (2): 242–50.

5. Weis-Müller B.T., Huber R., Spivak-Dats A., Turowski B., Siebler M., Sandmann W. Symptomatic acute occlusion of the internal carotid artery: reappraisal of urgent vascular reconstruction based on current stroke imaging. J. Vasc. Surg. 2008; 47 (4): 752–9.

6. Berthet J.P., Marty-Ané C.H., Picard E., Branchereau P., Mary H., Veerapen R. et al. Acute carotid artery thrombosis: description of 12 surgically treated cases. Ann. Vasc. Surg. 2005; 19 (1): 11–8.

7. Murata T., Horiuchi T., Nitta J., Sakai K., Ogiwara T., Kobayashi S. et al. Urgent open embolectomy for cardioembolic cervical internal carotid artery occlusion. Neurosurg. Rev. 2010; 33 (3): 341–8.

8. Wolf R.L., Detre J.A. Clinical neuroimaging using arterial spinlabeled perfusion magnetic resonance imaging. Neurotherapeut. 2007; 4 (3): 346–59.

9. Максимова М.Ю., Коробкова Д.З., Кротенкова М.В. Методы визуализации пенумбры при ишемическом инсульте. Вестник рентгенологии и радиологии. 2013; 6: 57–66. [Maksimova M.Yu., Korobkova D.Z., Krotenkova M.V. Imaging of the ischemic penumbra in acute stroke. Vestnik Rentgenologi i Radiologii (Russian Journal of Radiology). 2013; 6: 57–66 (in Russ.).]

10. Walker M.D., Marler J.R., Goldstein M. et al. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995; 273 (18): 1421–8.

11. Чечулов П.В., Вознюк И.А., Сорока В.В., Вараксина Е.А., Айдаев С.С., Зенин А.В. Каротидная эндартерэктомия в первые дни после ишемического инсульта безопасна и оправданна. Грудная и сердечно-сосудистая хирургия. 2013; 3: 24–9. [Chechulov P.V., Voznyuk I.A., Soroka V.V., Varaksin E.A., Aydaev S.S., Zenin A.V. Carotid endarterectomy in the first days after an ischemic stroke is safe and justified. Grudnaya i SerdechnoSosudistaya Khirurgiya (Thoracic and Cardiovascular Surgery, Russian journal). 2013; 3: 24–9 (in Russ.).]

12. Harbaugh R.E., Patel A. Surgical advances for extracranial carotid stenosis. Neurosurgery. 2014; 74 (Suppl. 1): S83–S91.

13. Крылов В.В., Леменев В.Л., Мурашко А.А., Лукьянчиков В.А., Далибалдян В.А. Лечение пациентов с атеросклеротическим поражением брахиоцефальных артерий в сочетании с интракраниальными аневризмами. Нейрохирургия. 2013; 2: 80–5. [Krylov V.V., Lemenev V.L., Murashko A.A., Luk’yanchikov V.A., Dalibaldyan V.A. Treatment of patients with atherosclerotic lesions of brachiocephalic arteries in conjunction with intracranial aneurysms. Neyrokhirurgiya (Russian Journal of Neurosurgery). 2013; 2: 80–5 (in Russ.).]

14. Bruls S., Van Damme H., Defraigne J.O. Timing of carotid endarterectomy: a comprehensive review. Acta Chir. Belg. 2012; 112 (1): 3–7.

15. Capoccia L., Sbarigia E., Speziale F., Toni D., Fiorani P. Urgent carotid endarterectomy to prevent recurrence and improve neurologic outcome in mild-to-moderate acute neurologic events. J. Vasc. Surg. 2011; 53 (3): 622–7.

16. Bartoli M.A., Squarcioni C., Nicoli F., Magnan P.E., Malikov S., Berger L. et al. Early carotid endarterectomy after intravenous thrombolysis for acute ischaemic stroke. Eur. J. Vasc. Endovasc. Surg. 2009; 5: 512–8.

17. Дуданов И.П., Васильченко Н.О., Коблов Е.С., Азиева А.З., Стерлин О.В., Бергер М.М. и др. Хирургическое лечение стенозированных сонных артерий у пациентов с выраженным неврологическим дефицитом в остром периоде ишемического инсульта. Нейрохирургия. 2013; 2: 18–24. [Dudanov I.P., Vasil’chenko N.O., Koblov E.S., Azieva A.Z., Sterlin O.V., Berger M.M. et al. Surgical treatment of stenotic carotid arteries in patients with severe neurological deficits in acute ischemic stroke. Neyrokhirurgiya (Russian Journal of Neurosurgery). 2013; 2: 18–24 (in Russ.).]

18. Capoccia L., Sbarigia E., Speziale F., Toni D., Biello A., Montelione N. et al. The need for emergency surgical treatment in carotid-related stroke in evolution and crescendo transient ischemic attack. J. Vasc. Surg. 2012; 55 (6): 1611–7.

19. Chalela J.A., Alsop D.C., GonzalezAtavales J.B., Maldjian J.A., Kasner S.E., Detre J.A. Magnetic resonance perfusion imaging in acute ischemic stroke using continuous arterial spin labeling. Stroke. 2000; 31 (3): 680–7.

20. Bokkers R.P., Hernandez D.A., Merino J.G., Mirasol R.V., van Osch M.J., Hendrikse J. et al. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke. 2012; 43 (5): 1290–94.

21. Tavares A., Caldas J.G., Castro C.C., Puglia P. Jr, Frudit M.E., Barbosa L.A. Changes in perfusion-weighted magnetic resonance imaging after carotid angioplasty with stent. Intervt. Neuroradiol. 2010; 16 (2): 161–9.

22. Hwang G., Oh C.W., Bang J.S., Jung C.K., Kwon O.K., Kim J.E. et al. Superficial temporal artery to middle cerebral artery bypass in acute ischemic stroke and stroke in progress. Neurosurgery. 2011; 68 (3): 723–39.

23. Doerfler A., Eckstein H.H., Eichbaum M., Heiland S., Benner T. et al. Perfusion-weighted magnetic resonance imaging in patients with carotid artery disease before and after carotid endarterectomy. J. Vasc. Surg. 2001; 34 (4): 587–93.

24. Van Laar P.J., Hendrikse J., Mali W.P., Moll F.L., van der Worp H.B., Osch M.J. et al. Altered flow territories after carotid stenting and carotid endarterectomy. J. Vasc. Surg. 2007; 45 (6): 1155–61.


Review

For citations:


Luk'yanchikov V.A., Shatokhina Yu.I., Udodov E.V., Tokarev A.S., Polunina N.A., Kudryashova N.E., Krylov V.V. ASSESSMENT OF CEREBRAL PERFUSION IN PATIENTS WITH HEMODYNAMIC ISCHEMIC STROKE UNDERGOING RECONSTRUCTIVE BRACHIOCEPHALIC ARTERY INTERVENTIONS. Journal of radiology and nuclear medicine. 2016;97(6):365-372. (In Russ.) https://doi.org/10.20862/0042-4676-2016-97-6-365-372

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