EARLY HEMODYNAMIC-CHANGES IN THE OPHTHALMIC ARTERY, SIPHON AND INTRACRANIAL-ARTERIES AFTER CAROTID ENDARTERECTOMY ESTIMATED BY TRANSCRANIALDOPPLER AND DUPLEX SCANNING

Objectives: To study early haemodynamic changes in connection with car otid endarterectomy (CE). Methods: Sixty-three consecutive patients, a verage age 64, with symptomatic stenosis in the internal carotid arter y (ICA) greater than or equal to 70% were examined clinically and by t ranscranial Doppler (TCD) 1 day before and within 48 h after CE. Duple x scanning of extracranial vessels was performed within 1 week after C E. Results: After CE, all retrograde systolic velocities (SV) in the o phthalmic artery (OA) and 9/10 retrograde mean velocities (MV) in the siphon changed to antegrade. Antegrade SV in the OA increased signific antly (p<0.001) only on the operated side. SV in the OA on the operate d side correlated (p<0.05) with MV in the siphon, and pulsatility inde x (PI) in the middle cerebral artery (MCA, p<0.001). MV in the MCA inc reased from 46 +/- 12 cm/s to 59 +/- 21 cm/s after CE and in the ACA w ith normal flow from 54 +/- 19 cm/s to 62 +/- 28 cm/s (p<0.001 and <0. 05, respectively) only on the operated side. Stump pressure correlated (p<0.01) with SV in the OA and PI in the MCA and was higher (59 +/- 1 6 mmHg, p<0.01) in the group with antegrade flow in the OA compared to the group with retrograde flow in the OA (43 +/- 15 mmHg). Conclusion : TCD and duplex gives important early information about potency of th e ICA and haemodynamic intracranial changes after CE.