Description:
<jats:p>Introduction. Cerebral vasomotor reactivity (VMR) represents an
autoregulatory response of the arterial trunks on the specific vasoactive
stimuli, most commonly CO2. Objective. The aim of this retrospective study
was to compare VMR in high-grade symptomatic (SCAS) and asymptomatic carotid
stenosis (ACAS), using the apnea test to evaluate the hemodynamic status.
Methods. The study included 50 patients who were hospitalized at the
neurology and vascular surgery departments as part of preparation for carotid
endarterectomy. We evaluated VMR by calculating the breath holding index
(BHI) in 34 patients with SCAS and 16 patients with ACAS, with isolated
high-grade carotid stenosis. We evaluated the impact of risk factors and
collateral circulation on BHI, as well as the correlation between the degree
of carotid stenosis and BHI. Results. A pathological BHI was more frequent in
the SCAS group (p<0.01). There was no difference in the range of BHI values
between the groups, both ipsilaterally and contralaterally. Only male gender
was associated with pathological BHI in both groups (p<0.05). Collateral
circulation did not exist in over 60% of all subjects. We confirmed a
negative correlation between the degree of carotid stenosis and BHI.
Conclusion. SCAS and ACAS patients present with different hemodynamics. While
ACAS patients have stable hemodynamics, combination of hemodynamic and
thromboembolic effects is characteristic of SCAS patients.</jats:p>