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The effect of revascularization of the internal Carotid artery on the Microcirculation of the eye


D. G. Iosseliani , N. S. Bosha , T. S. Sandodze , A. V. Azarov , S. P. Semitko

Abstract

This research studied the changes in the perfusion of the retina and the optic nerve head in patients after carotid endarterectomy and carotid stenting with the use of optical coherence tomography angiography. The study involved 30 patients with hemodynamically significant stenosis (≥ 75 %) of the right or left internal carotid artery (ICA). The patients were divided into two groups: Group 1 — patients after stenting of the ICA (17 patients), and Group 2 — patients after carotid endarterectomy performed from the carotid artery (13 patients). OCT-A performed before the revascularization procedures had not revealed any significant differences in terms of the blood flow density on the side of the stenosed and non-stenosed carotid arteries. In the early postsurgery period, the blood flow density increased in the macular area both at the level of the surface and the deep layer (p < 0.05). It should be noted that the increase in the blood flow density was more pronounced in the area of the capillary plexus and the capillary choroid of the ONH (p < 0.01). The studied parameters obtained after stenting and carotid endarterectomy were not veraciously different. At the follow-up examination, three months after the revascularization procedures, optical coherence tomography angiography showed a moderate decrease in some flow density parameters, compared to the results obtained immediately after the procedure; however, they remained higher than the initial values, both on the affected and the contralateral sides. The first experiment in studying the brain structure microcirculation (the retina and the ONH) after carotid stenting (CS) and carotid endarterectomy (CEAE) showed that after revascularization, the eye retina perfusion parameters increase, which may serve as an indirect confirmation of an improvement in the cerebral perfusion after revascularization of the carotid arteries. The foregoing applies to both the CS and CEAE procedures. However, further accumulation of experience in this area is required for making conclusions.


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