{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:22:32Z","timestamp":1760016152249},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1996,4]]},"abstract":"\n Background and Purpose<\/jats:italic>\n Carotid percutaneous transluminal angioplasty (PTA) may offer an alternative treatment to carotid endarterectomy. However, in contrast to carotid endarterectomy, which has been shown to normalize impaired cerebral hemodynamics, the effects of carotid PTA are unknown. Therefore, we prospectively studied the effect of carotid PTA on both perioperative and postoperative cerebral hemodynamics.\n <\/jats:p>\n \n Methods<\/jats:italic>\n Eleven patients undergoing carotid PTA for symptomatic carotid artery stenosis were prospectively studied. Transcranial Doppler recordings from the ipsilateral middle cerebral artery (MCA) were performed during the procedure. In addition, MCA blood flow velocity and CO\n 2<\/jats:sub>\n reactivity were determined before PTA and at 2 days, 1 month, and 6 months after the procedure. The results were compared with those in 11 similar patients undergoing carotid endarterectomy in whom measurements were performed before and 1 month after the operation.\n <\/jats:p>\n \n Results<\/jats:italic>\n During carotid PTA, in 2 of 11 patients during passage of the balloon catheter through the stenosis, MCA blood flow velocity fell transiently. In 6 of 11 patients there was a reduction in flow velocity (>50%) during balloon deflation, but this lasted only a few seconds. After the procedure there was a significant improvement in ipsilateral hypercapnic reactivity: preoperative value, 59.8\u00b142.2% (mean\u00b1SD); 2 days, 77.9\u00b131.4%; 1 month, 88.7\u00b145.0%; 6 months, 89.8\u00b133.9%; and (ANOVA\n P<\/jats:italic>\n =.003) preoperative value versus 1 month,\n P<\/jats:italic>\n <.02; versus 6 months,\n P<\/jats:italic>\n <.02. In all cases in which reactivity was significantly impaired preoperatively, it returned to the normal range. Pulsatility index also increased significantly: preoperative value, 0.827\u00b10.251 (mean\u00b1SD); 2 days, 0.992\u00b10.262 (\n P<\/jats:italic>\n =.002). Contralateral MCA hypercapnic reactivity also improved after carotid PTA. There was a similar improvement in ipsilateral hypercapnic reactivity after carotid endarterectomy.\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n Carotid PTA results in a normalization of impaired hemodynamics, as assessed by CO\n 2<\/jats:sub>\n reactivity. The degree of improvement is similar to that seen after carotid endarterectomy.\n <\/jats:p>","DOI":"10.1161\/01.str.27.4.612","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"612-616","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Improvement in Cerebral Hemodynamics After Carotid Angioplasty"],"prefix":"10.1161","volume":"27","author":[{"given":"Hugh S.","family":"Markus","sequence":"first","affiliation":[{"name":"From the Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.); Division of Clinical Neuroscience, St George\u2019s Hospital Medical School (H.S.M, M.M.B.); Department of Neuroradiology, Atkinson Morley\u2019s Hospital (A.C.); and Departments of Radiology (T.B.) and Vascular Surgery (R.T.), St George\u2019s Hospital, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Clifton","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.); Division of Clinical Neuroscience, St George\u2019s Hospital Medical School (H.S.M, M.M.B.); Department of Neuroradiology, Atkinson Morley\u2019s Hospital (A.C.); and Departments of Radiology (T.B.) and Vascular Surgery (R.T.), St George\u2019s Hospital, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Buckenham","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.); Division of Clinical Neuroscience, St George\u2019s Hospital Medical School (H.S.M, M.M.B.); Department of Neuroradiology, Atkinson Morley\u2019s Hospital (A.C.); and Departments of Radiology (T.B.) and Vascular Surgery (R.T.), St George\u2019s Hospital, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Taylor","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.); Division of Clinical Neuroscience, St George\u2019s Hospital Medical School (H.S.M, M.M.B.); Department of Neuroradiology, Atkinson Morley\u2019s Hospital (A.C.); and Departments of Radiology (T.B.) and Vascular Surgery (R.T.), St George\u2019s Hospital, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.); Division of Clinical Neuroscience, St George\u2019s Hospital Medical School (H.S.M, M.M.B.); Department of Neuroradiology, Atkinson Morley\u2019s Hospital (A.C.); and Departments of Radiology (T.B.) and Vascular Surgery (R.T.), St George\u2019s Hospital, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92916-P"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Brown MM. Balloon angioplasty for cerebrovascular disease. Neurol Res. 1992;14(suppl):159-163.","DOI":"10.1080\/01616412.1992.11740040"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.8.1045"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.8.3135641"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.12.7974580"},{"key":"e_1_3_2_7_2","unstructured":"Takagi Y Hata T Ishiboti K Kitagawa Y. Cerebral blood flow and CO2 reactivity before and after carotid endarterectomy. Acta Neurol Scand. 1979;60(suppl 71):506-507."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800800212"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.23.2.1561643"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.27.4.612","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:36:40Z","timestamp":1715553400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.27.4.612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,4]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1996,4]]}},"alternative-id":["10.1161\/01.STR.27.4.612"],"URL":"https:\/\/doi.org\/10.1161\/01.str.27.4.612","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,4]]},"assertion":[{"value":"1995-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-01-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}