The Impact of Carotid Angioplasty and Stenting on the Cerebrovascular Reactivity

OBJECTIVE: To evaluate the effect of carotid angioplasty and stenting (CAS) on postoperative cerebrovascular reactivity (CVR) and its independent predictors. METHODS: During July 2008 and September 2009, 37 patients undergone CAS were enrolled in this study. Breath holding tests using transcranial Doppler were performed for each patient before, 1 to 2 days, and 3 to 10 months after the procedure. CVR was evaluated by the breath holding index (BHI). Repeated measures analysis of variance was employed to detect the BHI changes after CAS. Multivariate linear regression was used to identify the independent predictors for BHI. RESULTS: A significant improvement of the ipsilateral BHI values was observed after stenting (P < 0.05). The follow-up BHI values were positively correlated with those after procedures (β = 1.030, P < 0.001), while negatively correlated with tandem stenoses (β = -0.016, P = 0.002). CONCLUSIONS: CAS results in an immediate improvement and a gradual normalization of the ipsilateral CVR. Tandem stenoses are an independent predictor for CVR.