내경동맥폐쇄성질환환자에서의안동맥을통한측부순환의분석

Abstract

B a c k g ro u n d: Transcranial Doppler ultrasonography(TCD) is a non-invasive and easily applicable method toevaluate the ophthalmic artery flow and cerebral hemodynamics. The aim of this study is to evaluate the signifi-cance of ophthalmic artery(OA) flow detected by TCD in the assessment of cerebral hemodynamics in patientswith internal carotid artery (ICA) occlusive disease. Methods: Eighty-five patients with unilateral ICA occlusionor stenosis confirmed by cerebral angiography were enrolled in this study. We evaluated the patterns of OA flowby TCD, patterns of cerebral ischemic changes on MRI, and degree of carotid stenosis assessed by angiography.The flow direction of OA were compared with degree of carotid stenosis and patterns of ischemic changes.Results: OA signals were reversed in 17(80.9%) out of 21 patients with ICA occlusion. Among the patients with90~99% ICA stenosis, OA signals were reversed in 20 patients(74%). Only one out of 29 patients showedreversed OA signal in less than 90% stenosis group. The frequency of reversal of OA flow was not significantlydifferent between positive MRI lesion (presence of territorial infarction or borderzone infarction in ICA territory)group and negative MRI lesion group in both ICA occlusion (p=0.498) and 90~99% stenosis(p=0.175) patients.Conclusion: Reversed OA flows on TCD indicate severe ICA stenosis of more than 90%. But OA collateral flowhas little significance in cerebral hemodynamic status.