Atherosclerotic diseases including stroke are the leading causes of morbidity, mortality as well as disability in industrialized countries. Carotid endarterectomy was long considered the stan- dard approach for the treatment of atherosclerotic carotid disease, one of major causes of stroke. Over time, carotid artery stenting (CAS) has evolved as an alternative approach and is considered equivalent to surgical treatment in selected patients. Particularly in the last years, CAS has gained attention with the increasing knowledge regarding atherosclerotic plaque and cerebrovascular flow. In our study, we focused on patients undergoing CAS and evaluated structural and hemodynamic characteristics of atherosclerotic plaques together with relation to endovascular manipulation. The major part of the study includes transcranial doppler ultrasound evaluation which is able to detect flow in major cerebral arteries as well as to detect microembolizations of atherosclerotic particles during CAS. In eligible patients, we investigated the usefulness of cerebrovascular reserve (CVR) testing to predict severe hemodynamic changes in ipsilateral middle cerebral artery induced by temporary carotid occlusion during proximally protected CAS. CVR was tested by means of a breath-holding test and ophthalmic artery flow...
| Identifer | oai:union.ndltd.org:nusl.cz/oai:invenio.nusl.cz:397878 |
| Date | January 2019 |
| Creators | Špaček, Miloslav |
| Contributors | Zemánek, David, Malík, Jan, Pařenica, Jiří |
| Source Sets | Czech ETDs |
| Language | Czech |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis |
| Rights | info:eu-repo/semantics/restrictedAccess |
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