Cerebral hemodynamic changes and collateral circulation pathways in patients with steno-occlusive disease of common carotid artery

[Objective] To explore the cerebral hemodynamic changes and collateral circulation pathways in patients with serious stenosis or occlusion of common carotid artery (CCA). [Methods] Sixty seven patients with CCA serious stenosis or occlusion were selected to serve as patient group and sixty patients without stenosis disease of intracranial and carotid artery were selected to serve as controls. All patients were measured by transcranial doppler (TCD) and cervical continuous-wave doppler(CWD). [Results] In 35 stenosis patients, the focus serious stenosis flow of CCA was found in 15 patients(43%). The flow signal of disease side CCA was not found in 32 occlusion patients. With distal internal carotid artery and middle cerebral artery, both TCD and CWD showed abnormal flow waveforms that manifested blunt systolic peak and delayed systolic velocity acceleration. Their blood flow velocity and pulsitility index were significantly lower than controls (P 0.01). TCD and CWD showed collateral patency of vertebral artery-external carotid artery in 79% and collateral patency of circle of Willis in 91% of patient group.The ophthalmic artery collateral was not found in all patients. [Conclusions] Both TCD and CWD might further help to know the hemodynamic change and collateral circulation pathway of CCA serious stenosis or occlusion. It was suggested that they might be important and objective index in determining the diagnosis and in exploring deeply the pathogenesis of ischemic cerebrovascular disease.