Evaluation of the brain perfusion malfunction in cases where endovascular treatment is planned due to the stenosis of the Carotis artery

Stroke is the 3rd common causes of death worldwide. About 80% of the cerebrovascular pathologies consist of ischemic strokes, whereas 35% of the ischemic strokes are reported to develop due to extracranial large artery stenosis. Atherosclerotic carotid artery stenosis is associated with a high risk of vascular events.Evaluation of the brain perfusion in patients for whom stenozis is detected in the ICA is important for determining both an indication for the treatment and whether or not a stent treatment would increase the perfusion.In our study, the effects of the stenosis on the brain perfusion and whether or not the treatment has an effect on the perfusion have been examined in the cases where carotis artery stenosis was detected and a treatment was planned. Using a 64-detector CT (VCT XTe LightSpeed; General Electric, Milwaukee, USA), a computer tomography to examine the brain perfusion has been performed before the stent treatment on the 34 cases for which an indication for treatment was one-sidedly detected in the carotis angiography performed in our clinic and after the stent treatment on 14 of these cases where clear perfusion malfunction was detected.The analysis has been performed using the GE perfusion 4 software. The CBV, CBF and MTT values of the 34 cases taken from the hemisphere with the ICA stenosis and from the normal hemisphere have been compared with each other. In 27 cases, CBV and CBF values have been detected to increase in the hemisphere with stenosis, whereas in 28 cases, MTT values has been detected to elongate. Upon comparing the CBV, CBF and MTT values of the hemisphere with stenozis for the 14 cases before and after the treatment, CBV and CBF have been detected to decrease and MTT has been detected to shrink after the stent treatment and the results have been found to be statistically significant.To conclude, we believe that, in the carotis artery stenosis, the brain perfusion is clearly affected and the Perfusion CT is useful in determining the stent timing of the clinically stable patients and in determining the indication for stent treatment.Keywords: ICA stenosis, Brain Perfusion CT