Key result
The degree of carotid stenosis correlates poorly with ipsilateral cerebral hemodynamics, as collateral circulation is the primary determinant of cerebral perfusion pressure and blood flow.
Population
Patients with ischemic cerebrovascular disease and carotid stenosis
Design
Review
Authors
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Questions reliance on stenosis thresholds for carotid decisions; leaves open whether routine hemodynamic assessment improves outcomes.
The concept of a universally 'hemodynamically significant' carotid stenosis should be abandoned in favor of individual assessment of cerebral hemodynamics and collateral circulation.
William J. Powers (1991) conducted a review in ischemic cerebrovascular disease. The degree of carotid stenosis correlates poorly with ipsilateral cerebral hemodynamics, as collateral circulation is the primary determinant of cerebral perfusion pressure and blood flow.
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