{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:47:08Z","timestamp":1756460828832},"reference-count":21,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold><jats:italic>Introduction:<\/jats:italic><\/jats:bold> Impaired collateral circulation can lead to stroke during carotid endarterectomy. Carotid stump pressure (CSP) is used as a surrogate measure of collateral flow. The objective was to determine whether anatomical features obtained from digital subtraction angiography correlate with CSP during temporary internal carotid artery occlusion. The second objective was to use these features in combination to predict CSP. <jats:bold><jats:italic>Methods:<\/jats:italic><\/jats:bold> Digital subtraction angiographies from 102 patients obtained before endarterectomy were reviewed for anatomical variables including: degree of ipsilateral and contralateral carotid artery stenosis; patency of the anterior communicating artery; presence of cross-flow into ipsilateral middle cerebral artery branches; and size (&lt; or \u22651 mm calibre) of the ipsilateral proximal anterior cerebral (A1), the contralateral A1, and the ipsilateral posterior communicating arteries. At surgery, systemic mean arterial pressure (MAP) and CSP were recorded. Multiple regression analysis was used to assess for anatomical features significantly associated with CSP. A \u201cpredicted CSP\u201d equation was applied to 54 subsequent patients and correlated with measured CSP. <jats:bold><jats:italic>Results:<\/jats:italic><\/jats:bold> Variables correlating with CSP included MAP (p=0.001); the presence of severe contralateral carotid stenosis (p=0.002); patency of the anterior communicating artery (p=0.013); and the size of the contralateral A1 segment (p=0.029). Angiographic cross-flow, ipsilateral A1 size, and ipsilateral posterior communicating artery size were not significant. Predicted CSP correlated significantly with measured CSP (p<jats:italic>&lt;<\/jats:italic>0.0001; <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>=0.34). <jats:bold><jats:italic>Conclusions:<\/jats:italic><\/jats:bold> Anatomical features and systemic MAP are associated with carotid stump pressure during internal carotid artery occlusion and account for a significant amount of its variation.<\/jats:p>","DOI":"10.1017\/cjn.2016.9","type":"journal-article","created":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:52:34Z","timestamp":1459385554000},"page":"533-537","source":"Crossref","is-referenced-by-count":7,"title":["Circle of Willis Collateral During Temporary Internal Carotid Artery Occlusion I: Observations From Digital Subtraction Angiography"],"prefix":"10.1017","volume":"43","author":[{"given":"Stephen P.","family":"Lownie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramiro","family":"Larrazabal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian K.","family":"Kole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,3,31]]},"reference":[{"key":"S0317167116000093_ref12","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1948.5.2.0178"},{"key":"S0317167116000093_ref8","first-page":"1937","article-title":"Comparison of technetium Tc 99m hexamethylpropyleneamine oxime single-photon emission tomograph with stump pressure during the balloon occlusion test of the internal carotid artery","volume":"26","author":"Tomura","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"key":"S0317167116000093_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)80275-X"},{"key":"S0317167116000093_ref4","first-page":"76","article-title":"Hemodynamic alterations in patients with cerebral arterial insufficiency before and after operation","volume":"48","author":"Crawford","year":"1960","journal-title":"Surgery"},{"key":"S0317167116000093_ref16","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1977.46.2.0185"},{"key":"S0317167116000093_ref17","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1965.22.3.0241"},{"key":"S0317167116000093_ref5","first-page":"953","article-title":"Intraoperative measurement of carotid back pressure as a guide to operative management for carotid endarterectomy","volume":"72","author":"Hays","year":"1972","journal-title":"Surgery"},{"key":"S0317167116000093_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1963.00460040068006"},{"key":"S0317167116000093_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"S0317167116000093_ref13","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.79.3.0379"},{"key":"S0317167116000093_ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406023302204"},{"key":"S0317167116000093_ref15","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1965.22.1.0040"},{"key":"S0317167116000093_ref9","first-page":"52","article-title":"Cerebral perfusion pressure and collateral resistance during carotid clamping. 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