Key result
Carotid endarterectomy fails to change cerebral microcirculation blood flow velocity or pulsatility at three months.
Why the study?
Patients with symptomatic high degree carotid artery stenosis often have reduced cerebral perfusion pressure without sufficient collaterals, prompting evaluation of changes in blood flow velocity and pulsatility in cerebral perforating arteries following CEA.
Does carotid endarterectomy improve mean blood flow velocity and pulsatility in cerebral perforating arteries in patients with symptomatic high degree carotid artery stenosis?
Comparison
Postoperative vs preoperative measurements following CEA
Design
Monocentre prospective observational study
Authors
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No microcirculatory hemodynamic improvement after CEA in this cohort; leaves open effects on outcomes or need for larger prospective trials.
Observational (n=15)
No
Does carotid endarterectomy improve mean blood flow velocity and pulsatility in cerebral perforating arteries in patients with symptomatic high degree carotid artery stenosis?
Effect estimate: 14% increase (95% CI -1.30-7.05)
Absolute Event Rate: 32.3% vs 28.2%
p-value: p=0.16
Carotid endarterectomy for symptomatic high-degree stenosis did not result in statistically significant changes in cerebral blood flow velocity or pulsatility in small perforating arteries at 3 months post-intervention.
Bresser et al. (2025) conducted an observational in Symptomatic high degree carotid artery stenosis (n=15). Carotid endarterectomy vs. Preoperative baseline was evaluated on Change in mean blood flow velocity (Vmean) at the first segment of the middle cerebral artery (M1) (14% increase, 95% CI -1.30-7.05, p=0.16). Carotid endarterectomy did not result in statistically significant changes in mean blood flow velocity or pulsatility index in the cerebral microcirculation at three months post-intervention.
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