Observational studyJournal of neurosurgery2014
Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis.
Observational study in Journal of neurosurgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. It is linked to trial NCT00597883 (Neurologic and Neuropsychometric Outcome in Patients Undergoing Carotid Endarterectomy), which is not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neurologic and Neuropsychometric Outcome in Patients Undergoing Carotid Endarterectomy
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cerebrolysin for functional recovery in patients with acute ischemic stroke: a meta-analysis of randomized controlled trials.Drug design, development and therapy · 2017Pooled it
- Cognitive impairment in patients with middle cerebral artery severe stenosis or occlusion is associated with hemodynamic abnormalities.BMC neurology · 2026Observational
- New evidence for fractional pressure ratio prediction by pulsatility index from transcranial Doppler in patients with symptomatic cerebrovascular stenosis disease.Quantitative imaging in medicine and surgery · 2024Article
- Application of the Intracranial Arterial Pulsatility Index for Determination of Prognosis after Lacunar Infarct.Advanced biomedical research · 2023Article
- Visualization of Murine Vascular Remodeling and Blood Flow Dynamics by Ultra-High-Frequency Ultrasound Imaging.International journal of molecular sciences · 2022Article
- Transcranial Doppler study in acute spontaneous intracerebral hemorrhage: The role of pulsatility index.Journal of cerebrovascular and endovascular neurosurgery · 2021Article
- Intermittent compression of the calf muscle as a countermeasure to protect blood pressure and brain blood flow in upright posture in older adults.European journal of applied physiology · 2021Article
- Disrupted Topological Organization of Functional Networks in Asymptomatic Carotid Plaque Without Significant Carotid Stenosis: A Resting-State fMRI Study.Frontiers in human neuroscience · 2021Article
- Easily Screenable Characteristics Associated with Cognitive Improvement and Dysfunction After Carotid Endarterectomy.World neurosurgery · 2019Observational
- Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion.BioMed research international · 2016Article
- Carotid artery stiffness and hemodynamic pulsatility during cognitive engagement in healthy adults: a pilot investigation.American journal of hypertension · 2015Article
- The Significance of Cerebral Hemodynamics Imaging in Carotid Endarterectomy: A Brief Review.Neurologia medico-chirurgica · 2015Review
- Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke.Neuropsychiatric disease and treatment · 2014Article
Corrections and comments
- Expression of concern
Authors and funding
3 authors.
Funding
Abstract
objectTranscranial Doppler (TCD) is frequently used to evaluate peripheral cerebral resistance and cerebral blood flow (CBF) in the middle cerebral artery prior to and during carotid endarterectomy (CEA). Patients with symptomatic carotid artery stenosis may have reduced peripheral cerebral resistance to compensate for inadequate CBF. The authors aim to determine whether symptomatic patients with reduced peripheral cerebral resistance prior to CEA demonstrate increased CBF and cognitive improvement as early as 1 day after CEA.
methodsFifty-three patients with symptomatic CEA were included in this observational study. All patients underwent neuropsychometric evaluation 24 hours or less preoperatively and 1 day postoperatively. The MCA was evaluated using TCD for CBF mean velocity (MV) and pulsatility index (PI). Pulsatility index ≤ 0.80 was used as a cutoff for reduced peripheral cerebral resistance.
resultsSignificantly more patients with baseline PI ≤ 0.80 exhibited cognitive improvement 1 day after CEA than those with PI > 0.80 (35.0% vs 6.1%, p = 0.007). Patients with cognitive improvement had a significantly greater increase in CBF MV than patients without cognitive improvement (13.4 ± 17.1 cm/sec vs 4.3 ± 9.9 cm/sec, p = 0.03). In multivariate regression model, a baseline PI ≤ 0.80 was significantly associated with increased odds of cognitive improvement (OR 7.32 [1.40-59.49], p = 0.02).
conclusionsSymptomatic CEA patients with reduced peripheral cerebral resistance, measured as PI ≤ 0.80, are likely to have increased CBF and improved cognitive performance as early as 1 day after CEA for symptomatic carotid artery stenosis. Revascularization in this cohort may afford benefits beyond prevention of future stroke. Clinical trial registration no: NCT00597883 ( ClinicalTrials.gov ).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.