Introduction: The authors analyzed the effects of STA-MCA bypass on ophthalmic artery flow in patients with occlusive internal carotid artery disease. Methods: We examined ophthalmic artery flow using color Doppler flow imaging in 88 patients with occlusive internal carotid artery disease treated with STA-MCA bypass. Results: (1)Before bypass, 18 patients showed antegrade flow, and 70 showed reversed flow. At 1 month and 3 months after bypass, antegrade ophthalmic artery flow was seen in 42 patients and 56 patients, respectively (p<0.05). (2)Ophthalmic artery mean peak systolic flow velocity (Vs) was -0.27m/s before bypass. The mean Vs increased to -0.06m/s at 1 month after bypass, and was 0.05m/s at 3 months after bypass (p<0.05). At 6 months after bypass, there was no significant change of the mean Vs. In the patients who had preoperative antegrade ophthalmic artery flow, there was no significant change in Vs during the course. Conclusion: STA-MCA had a significant effect in improving ophthalmic artery flow within 3 months, especially in patients showing revered ophthalmic artery flow preoperatively.
We hypothesized that hemodynamic parameters of the extracranial internal carotid artery (ICA) can reflect hemodynamic change in the middle cerebral artery (MCA) in patients with cerebral infarction (CI). In order to test this hypothesis, we evaluated the hemodynamic relationship between the ICA and MCA. We used TC-CFI and carotid ultrasonography to examine patients with CI within 14 days after onset. In 44 patients with bilateral temporal echo windows without severe stenosis or occlusion of the ICA, the hemodynamic correlation between the ICA and the MCA was evaluated for five parameters (peak systolic velocity, end-diastolic velocity, time-averaged maximum velocity, resistance index, and pulsatility index: PI). In 28 patients who had a CI in the MCA territory, PI showed a reasonable correlation between the two arteries (r=0.71 on the normal side, r=0.68 on the lesion side). Patients in whom the PI value demonstrated a larger value on one side were divisible into the following four groups: A; PI in both the ICA and MCA> 1.0, B; PI-MCA>1.0 and PI-ICA<1.0, C; PI-MCA< and PI-ICA>1.0, D; PI in both arteries<1.0. Almost all of the patients in group A (53.8%) had a history of severe vascular disease (SVD). Measurement of PI in the extracranial ICA can be useful for predicting the hemodynamic condition of the MCA in patients with CI, including those with SVD.