Evaluation of cerebrovascular reserve in asymptomatic patients with severe carotid artery stenosis

Czech version

Authors: M. Špaček
Authors‘ workplace: Kardiologická klinika 2. LF UK a FN v Motole, Praha
Published in: Kardiol Rev Int Med 2015, 17(1): 11-14
Category: Cardiology Review

Overview

Atherosclerotic carotid artery disease (CAD) is an important risk factor for the development of stroke, which is a major cause of mortality, morbidity and disability in both developed and developing countries. Its prevalence increases with age and is proportional to the patient’s risk profile. Its manifestation however, is variable, with cerebral collateral circulation associated with cerebrovascular reserve (CVR) being considered a major modifying factor. The optimal treatment choice for asymptomatic CAD patients is a continuously debated topic with no clear consensus to date, requiring a strictly individual approach to every single patient. The evaluation of CVR using transcranial Doppler ultrasound (TCD) is straightforward in majority of patients and may significantly contribute to the optimal treatment selection process. This article summarizes the current knowledge regarding CVR and its evaluation using TCD.

Keywords:
cerebrovascular reserve – transcranial Doppler ultrasound – carotid artery stenting – carotid endarterectomy – breath‑ holding test

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