London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 387 197 Vascular imaging Assessment of cerebral vascular autoregulation by multichannel near-infrared spectroscopy in patients with steno-occlusive disease of the middle cerebral artery A. Oldag1, M. Goertler2, A.-K. Bertz3, H.-J. Heinze4, K. Kopitzki5 Vascular and Stroke Center, Department of Neurology, Otto-von-Guericke-University of Mag-deburg, Magdeburg, GERMANY1, Vascular and Stroke Center, Department of Neurology, Ot-to- von-Guericke-University of Magdeburg, Magdeburg, GERMANY2, Vascular and Stroke Center, Department of Neurology, Otto-von-Guericke-University of Magdeburg, Magdeburg, GERMANY3, Vascular and Stroke Center, Department of Neurology, Otto-von-Guericke-University of Magde-burg, Magdeburg, GERMANY4, Leibnitz Institute for Neurobiology, Magdeburg, Magdeburg, GER-MANY5 Background: Steady-state cerebral perfusion is maintained by cerebral autoregulation resulting in a characteristic phase shift between hemodynamic response and blood pressure fluctuations. Steno-oc-clusion of cerebral arteries might diminish cerebral reserve capacity and thereby alter the phase re-lationship otherwise found in healthy individuals. Here the impact of unilateral steno-occlusion of the MCA on this phase relationship was investigated by multichannel near-infrared spectroscopy (NIRS). Methods: Nine patients (mean age 61.2 years; 56% male) with unilateral high-grade stenosis or seg-mental occlusion of the MCA were enrolled into this study. Non of the patients had a major stroke in their past medical history. Stable 0.1 Hz oscillations of hemodynamic parameters were induced by periodic paced respiration and continuously assessed for six minutes. Blood pressure was measured with a Finapres device while oxy- and deoxyhemoglobin fractions were continuously recorded by NIRS. Here, the 48-channel continuous wave NIRS system enabled assessment of hemodynamic pa-rameters in a spatially resolved manner for both affected and unaffected hemisphere. Results: Bilateral comparison exposed a significant impairment of vascular autoregulation on the affected hemisphere in 5 out of 9 patients. Here assessment of oscillatory coupling between arterial blood pressure and the NIRS time series by means of cross-correlation, coherence and phase-locking showed a reduced degree of spectral interaction. Conclusion: Our study suggests that spatial variations in vascular autoregulation can be assessed by multichannel NIRS in a non-invasive way. Given that impairments in vascular autoregulation were observed over cortical territories corresponding to steno-occlusion of cerebral arteries this finding are might be of clinical relevance. 198 Vascular imaging Long-term follow-up in patients with severe intracranial carotid artery stenosis diagnosed with CTA: strong predictor for poor outcome W.E. van der Stehen1, J.-D. Vermeij2, H.A. Marqueringj3, R. van den Berg4, C.B. Majoie5, P.J. Nederkoorn6 Academic Medical Center, Amsterdam, THE NETHERLANDS1, Academic Medical Center, Amsterdam, THE NETHERLANDS2, Academic Medical Center, Amsterdam, THE NETHER-LANDS3, Academic Medical Center, Amsterdam, THE NETHERLANDS4, Academic Medical Cen-ter, Amsterdam, THE NETHERLANDS5, Academic Medical Center, Amsterdam, THE NETHER-LANDS6 Background: The prevalence and impact of intracranial atherosclerosis in the white population is still sparsely researched and optimal treatment remains to be defined. Previously, we found that 84% of the patients with extracranial internal carotid artery (ICA) stenosis also had an intracranial ICA stenosis diagnosed with CT angiography (CTA). The purpose of this study was to investigate the relation between intracranial ICA stenosis on CTA images and the rate of recurrent stroke and other neurological and cardiovascular outcomes. Methods: We conducted a single center cohort study with long-term follow-up of all consecutive patients with TIA or infarct that underwent a CT angiography on a 64-section CT scanner for the assessment of a carotid artery stenosis between April 1, 2006 and December 31, 2008. Intracranial ICA stenosis was defined in three categories: absent, ≥30% (any stenosis) and ≥70% (severe stenosis). Primary outcome was recurrent TIA or infarct. Secondary out-comes were vascular death and functional outcome. Poor functional outcome was defined as mod-ified Rankin Scale (mRS) ≥3. Odds ratio’s (OR) were calculated for the three categories. Results: Eighty-four patients were included. Mean follow-up time was 4.1 years (±1.2 years). When com-paring patients with any stenosis with no stenosis, no significant increase in recurrent TIA (OR 0.51 (0.05 - 4.93)), infarct (OR 2.59 (0.14 - 48.6)), vascular death (OR 2.86 (0.15 - 53.4)) or poor func-tional outcome (OR 8.64 (0.48 - 157)) was found. When comparing patients with severe stenosis with <70% stenosis, still no significant increase of recurrent TIA (OR 1.12 (0.12 - 10.27)) or infarct (OR 0.63 (0.07 - 5.5)) was found. However more vascular deaths occurred (OR 7.85 (1.9 - 32.5)) and more patients had a poor functional outcome (OR 4.33 (1.15 - 16.37)). Conclusion: Severe in-tracranial ICA stenosis on CTA in a white population is associated with a higher rate of vascular death and a poor functional outcome.
Karger_ESC London_2013
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