ABSTRACT
Cerebrovascular reserve capacity (CVRC) is a hemodynamic parameter indicating the brain's capacity to overcome ischemia. Transcranial Doppler (TCD) is a useful device to measure CVRC, with high availability and low cost. The aim of the study is to investigate asymptomatic patients with affected CVRC, who could benefit from CEA. One hundred and forty five consecutive patients (60 symptomatic and 65 asymptomatic), with internal carotid artery (ICA) stenosis >70 % and 20 healthy individuals without internal carotid stenosis underwent TCD-inhalation CO(2) tests in order to measure the CVRC in both hemispheres of each patient. CVRC between asymptomatic and symptomatic patients were significantly different in the 95 % confidence interval (CI) as well as the mean CVRC value in contralateral carotid artery. The correlation between CVRC in the carotid artery with stenosis and the existence of symptoms is significant at the 0.01 level. Additionally, symptoms and CVRC of the contralateral carotid artery are also significant at the 0.05 level and CVRC values in asymptomatic patients and the control group at the 0.01 level. None of the covariant factors, except the age, are significantly correlated with CRVC. CVRC could be an early mark-index to evaluate the risk of stroke in this group of patients and to design their therapeutic approach.
Subject(s)
Carotid Stenosis/diagnostic imaging , Cerebrovascular Circulation , Age Factors , Aged , Aged, 80 and over , Algorithms , Carbon Dioxide , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/physiopathology , Carotid Artery, Internal/surgery , Carotid Stenosis/physiopathology , Carotid Stenosis/surgery , Endarterectomy, Carotid , Female , Functional Laterality , Humans , Male , Prospective Studies , Risk Assessment , Risk Factors , Stroke/etiology , Ultrasonography, Doppler, TranscranialABSTRACT
We report the preoperative diagnosis and surgical treatment of an abdominal aortic aneurysm (AAA) in association with a horseshoe kidney (HSK) in a 70-year-old man. Through a median laparotomy a vascular tube graft was successfully used for repair the AAA. The extensive parenchymal isthmus overlying the aneurysm remained intact.
