The effects of carotid endarterectomy on the retrobulbar circulation of patients with severe occlusive carotid artery disease - An investigation by color Doppler imaging

Objective: To analyze the effects of carotid endarterectomy on the retrobul bar circulation of patients with severe occlusive carotid artery disease (O CAD) by means of color Doppler imaging (CDI). Design: Prospective. Participants: A total of 17 consecutive patients with severe OCAD and neuro logic symptoms (with a history of transitory ischemic attack or cerebral va scular accident) participated. Intervention: All 17 patients underwent carotid endarterectomy. The CDI of both orbits was performed by one masked investigator before surgery and at 1 week and 1 month after surgery. Main Outcome Measures: Peak systolic velocity, end diastolic velocity, and resistive index of the ophthalmic, central retinal, and temporal short post erior ciliary arteries were measured. The authors compared the hemodynamic parameters at all intervals. Results: Peak systolic and end diastolic velocities in the ophthalmic, cent ral retinal, and temporal short posterior ciliary arteries increased signif icantly 1 week and I month after carotid endarterectomy (P < 0.05). After s urgery, the resistive indices in the central retinal and temporal short pos terior ciliary arteries decreased significantly at both intervals (P < 0.05 ). The six patients who had reversed ophthalmic artery flow before surgery showed forward ophthalmic artery flow after carotid endarterectomy, The con tralateral orbits showed no significant hemodynamic change after endarterec tomy (P < 0.05). Conclusions: Hemodynamic changes in patients with severe OCAD undergoing ca rotid endarterectomy suggest improvement in the ipsilateral retrobulbar blo od flow.