{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:52:43Z","timestamp":1760057563800,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Bilateral steno-occlusive disease of the internal carotid artery (ICA) carries an increased stroke risk with associated high morbidity and mortality. Management of these patients is often complex. In this study, we evaluate the value of non-invasive optimal vessel analysis quantitative magnetic resonance angiography (NOVA-qMRA) for studying flow and collateral patterns in patients with bilateral carotid steno-occlusive disease. Methods: Patients with bilateral ICA-stenosis \u2265 50% who received NOVA-qMRA were included in this study. The volume flow rates (VFRs) of the A2-segment of the anterior cerebral artery (A2-ACA), M1-segment of the middle cerebral artery (M1-MCA), and P2-segment of the posterior cerebral artery (P2-PCA) were analyzed. Demographic, clinical, and treatment data were collected. Results: Twenty-two patients (mean age \u00b1 SD: 68 \u00b1 10 years) were included. Nineteen patients (86%) were symptomatic. Thirteen patients (59%) were revascularized; among them, M1-VFR was significantly lower (p-value = 0.01) on the side selected for revascularization (88 mL\/min \u00b1 53) compared to the contralateral one (130 mL\/min \u00b1 56). P2-VFR was significantly higher (p-value = 0.04) in the treated subgroup (108 mL\/min \u00b1 41) than in the non-treated one (83 mL\/min \u00b1 34). Conclusions: The present study supports the use of NOVA-qMRA to study flow and collateral patterns in patients with bilateral steno-occlusive carotid disease, especially M1- and P2-VFR. This information may be helpful for decision-making and to tailor revascularization treatment.<\/jats:p>","DOI":"10.3390\/brainsci15020211","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:29:53Z","timestamp":1739935793000},"page":"211","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Value of Non-Invasive Optimal Vessel Analysis Quantitative Magnetic Resonance Angiography for Studying Flow and Collateral Patterns in Patients with Bilateral Carotid Steno-Occlusive Disease"],"prefix":"10.3390","volume":"15","author":[{"given":"Fiona","family":"Helg","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0424-1250","authenticated-orcid":false,"given":"Elisa","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"Inauen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara Maria","family":"H\u00f6bner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7246-3421","authenticated-orcid":false,"given":"Martina","family":"Seb\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tilman","family":"Schubert","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-0727","authenticated-orcid":false,"given":"Jorn","family":"Fierstra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Spinello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Wegener","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas R.","family":"Luft","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Cereneo Center for Neurology and Rehabilitation, 6354 Vitznau, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-5150","authenticated-orcid":false,"given":"Zsolt","family":"Kulcsar","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-4474","authenticated-orcid":false,"given":"Luca","family":"Regli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8687-3109","authenticated-orcid":false,"given":"Giuseppe","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"ref_1","first-page":"3238165","article-title":"Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life","volume":"2018","author":"Donkor","year":"2018","journal-title":"Stroke Res. 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