An analysis of blood flow indicators in pathological kinked internal carotid arteries with their orthostatic and rotational positions

L.A. Medvedeva

FGBU "RNTsKh im. akad. B.V. Petrovskogo" RAMN

O.I. Zagorulko

Petrovsky Russian Research Center of Surgery

ORCID: 0000-0002-2713-9577

Yu.V. Belov

RNTsKh im. akad. B.V. Petrovskogo RAMN

SPIN RSCI: 2740-1439
Scopus AuthorID: 7101862336
ORCID: 0000-0002-9280-8845

E.F. Dutikova

Petrovsky National Research Center of Surgery, Moscow, Russia

E.Yu. Malenkova

Petrovsky National Research Center of Surgery, Moscow, Russia

An analysis of blood flow indicators in pathological kinked internal carotid arteries with their orthostatic and rotational positions

Authors:

L.A. Medvedeva, O.I. Zagorulko, Yu.V. Belov, E.F. Dutikova, E.Yu. Malenkova

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(8): 68‑74

DOI: 10.17116/jnevro201911908168

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Medvedeva LA, Zagorulko OI, Belov YuV, Dutikova EF, Malenkova EYu. An analysis of blood flow indicators in pathological kinked internal carotid arteries with their orthostatic and rotational positions. S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(8):68‑74. (In Russ., In Engl.)
https://doi.org/10.17116/jnevro201911908168

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Objective. To assess the dynamics of blood flow in patients with hemodynamically significant pathological kinked internal carotid arteries (PK ICA) with their orthostatic and rotational positions. Material and methods. Eighty-six patients, including 35 with PK ICA due to fibromuscular dysplasia (FMD) and 51 with PK ICA due to hypertensive heart disease, and 20 healthy people were examined. All patients underwent Doppler ultrasound scanning. All indicators were evaluated in the position of the patient lying on his back and functional stress tests (orthostatic, rotational). Results. The peak systolic velocity, end diastolic velocity, peripheral resistance index did not differ significantly in patients with PK ICA due to FMD and hypertensive heart disease. The increase of blood flow in bends was significantly higher with S-shaped kinking, regardless of the reason for their formation (p<0.05). In orthostatic position, significant changes of hemodynamic parameters in ICA in healthy people did not occur. Moreover, more frequent formation of turbulent blood flows in the group with hypertensive heart disease (78%) and a decrease in LBFV in the standing position were found in patients with PK ICA due to FMD. Rotational position did not alter the hemodynamics in ICA in healthy people and significantly influenced the values of LBFV in patients with PK ICA. Conclusion. Changes in hemodynamic parameters in the area of kinking with orthostatic and rotational positions of ICA demonstrate more significant impairments in patients with PK ICA due to hypertensive heart disease compared to patients with FMD. The rotational position of PK ICA is the most informative for identifying turbulent blood flow and an increase in peak systolic velocity in the area of kinking.

Keywords:

pathological kinking of internal carotid arteries

diagnostics of pathological kinking of internal carotid arteries

duplex scanning of brachiocephalic arteries

orthostatic transposition of the internal carotid artery

rotational transposition of the internal carotid artery

Authors:

L.A. Medvedeva

FGBU "RNTsKh im. akad. B.V. Petrovskogo" RAMN

O.I. Zagorulko

Petrovsky Russian Research Center of Surgery

ORCID: 0000-0002-2713-9577

Yu.V. Belov

RNTsKh im. akad. B.V. Petrovskogo RAMN

SPIN RSCI: 2740-1439
Scopus AuthorID: 7101862336
ORCID: 0000-0002-9280-8845

E.F. Dutikova

Petrovsky National Research Center of Surgery, Moscow, Russia

E.Yu. Malenkova

Petrovsky National Research Center of Surgery, Moscow, Russia

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