Early haemodynamic changes in the ophthalmic artery, siphon and intracranial arteries after carotid endarterectomy estimated by transcranial doppler and duplex scanning

Objectives:To study early haemodynamic changes in connection with carotid endarterectomy (CE).Methods:Sixty-three consecutive patients, average age 64, with symptomatic stenosis in the internal carotid artery (ICA) ≥70% were examined clinically and by transcranial Doppler (TCD) 1 day before and within 48 h after CE. Duplex scanning of extracranial vessels was performed within 1 week after CE.Results:After CE, all retrograde systolic velocities (SV) in the ophthalmic artery (OA) and 9/10 retrograde mean velocities (MV) in the siphon changed to antegrade. Antegrade SV in the OA increased significantly (p<0.001) only on the operated side. SV in the OA on the operated side correlated (p<0.05) with MV in the siphon, and pulsatility index (PI) in the middle cerebral artery (MCA, p<0.001). MV in the MCA increased from 46 ± 12 cm/s to 59 ± 21 cm/s after CE and in the ACA with normal flow from 54 ± 19 cm/s to 62 ± 28 cm/s (p<0.001 and <0.05, respectively) only on the operated side. Stump pressure correlated (p<0.01) with SV in the OA and PI in the MCA and was higher (59 ± 16 mmHg, p<0.01) in the group with antegrade flow in the OA compared to the group with retrograde flow in the OA (43 ± 15 mmHg).Conclusion:TCD and duplex gives important early information about patency of the ICA and haemodynamic intracranial changes after CE