Middle Cerebral, Internal Carotid, Results Results

and Common Carotid Artery SUBJECT SELECTION FLOWCHART Table 3. Pulsatility index based on MRI findings in CSVD
Pulsatility Index in Assessed for eligibility (n=167) Lacunar Microbleeds Perivascular Fazekas
Cerebral Small Vessel Disease Excluded (n=88)
infarcts (N=7) (N=2) spaces ≥11 grade ≥2
(N=3) (N=6)
Putri Widya Andini1, Taufik Mesiano1,Ansi Rinjani1, Mohammad Reynalzi • Cardiac arrhythmias (n= 3)
Yugo2, Reyhan Eddy Yunus2, Mohammad Kurniawan1, Rakhmad Hidayat1, PI MCA 134 (1.06-1.97) 1.89 ± 0.94 1.13 ± 0.3 1.5 (0.6)
• Stenosis >50% (n= 12)
Al Rasyid1, Salim Harris1 • Missing TCD/CD parameter (n=7) PI ICA 1.35 ± 0.3 1.1 ± 0.31 1.34 ± 0.29 1.35 (0.3)
1 Department of Neurology, Cipto Mangunkusumo Hospital, Jakarta – • Missing CT/MRI (n= 50) PI CCA 1.4 ± 0.35 1.33 ± 0.41 1.58 ± 0.24 1.57 (0.39)
Faculty of Medicine Universitas Indonesia, Indonesia • Other findings than ischemic stroke in CT/MRI Data are median (IQR) and mean ± SD
2 Department of Radiology, Cipto Mangunkusumo Hospital, Jakarta – (n=16)
Faculty of Medicine Universitas Indonesia, Indonesia Taking age into account, we found no significant association between PI
Subjects included in the analysis (n=79) and CSVD burden and total SVD score
CSVD (n=43); nonCSVD (n=36)

Analysed TCD (n=66) Discussion

Analysed MRI (n=14) • CSVD accounts for up to 50% of all ischemic strokes
Introduction • We found no significant mean difference of PI between CSVD and
Abbrv. CSVD, cerebral small vessel disease; TCD, transcranial doppler nonCSVD
• Ischemic strokes are the most common type of stroke, with lacunar Table 1. Baseline characteristics of study participants • A possible explanation for these results may be due to the calculation
infarction as the main subtype (45%)1 of the PI which depends on the difference between PSV and EDV,
• Pulsatility index (PI) of middle cerebral artery (MCA), internal carotid Characteristics CSVD (N= 43) nonCSVD (N= 36) p thus it may not be suitable for evaluating vascular resistance when
artery (ICA), and common carotid artery (CCA) in lacunar infarction Age >60 years, n (%) 22 (51.2) 5 (13.9) 0.001* the two parameters have low values as shown in this study.5
reflect distal vascular resistance and large-artery stiffness.2-4 • Large-artery stiffness may lead to an increase in pulsatile flow
Male, n (%) 24 (55.8) 28 (77.8) 0.04*
transmission along the carotid arteries to cerebral vessels nwhich then
Objectives Risk factors >2, n (%) 31 (72.1) 27 (75) 0.77 contributes to the pathophysiology of CSVD,4,6 however we found no
Describe the demographic features and hemodynamic parameter changes Heart disease, n (%) 9 (20.9) 10 (27.8) 0.48 evidence of correlation between PI of MCA, ICA, and CCA with CSVD
of intra- and extracranial vessels of patients with CSVD (MCA, ICA, and CCA) Hypertension, n (%) 38 (88.4) 34(94.4) 0.45 burden and total SVD score. This discrepancy with previous studies could
be attributed to smaller sample size of our study
Diabetes mellitus, n (%) 23 (53.5) 14 (38.9) 0.2
Methods
Dyslipidemia, n (%) 7 (16.3) 5 (13.9) 0.77 Conclusion
Retrospective cross-sectional study; Neurology outpatient clinic Cipto History of smoking, n (%) 9 (24.3) 15 (45.5) 0.06
Mangunkusumo Hospital, Jakarta, Indonesia; from January-June 2020 • The pulsatility index of CCA, ICA and MCA tend to increase in CSVD,
Table 2. Pulsatility index of CCA, ICA, and MCA showing a greater distal vascular resistance and large extracranial artery
INCLUSION CRITERIA
stiffness.
Pulsatility index (PI) CSVD (N= 43) nonCSVD (N= 36) p
≥18; Diagnosed with CSVD; CT-scan/MRI and transcranial Doppler and • The findings of this study suggest the potential use of treatment aiming
carotid duplex ultrasound were done within a month of diagnosis CCA, median (IQR) 1.48 (1.3-1.68) 1.49 (1.37-1.84) 0.45 to decrease the vascular resistance to prevent CSVD and further
ICA, mean ± SD 1.12 ± 0,3 1.22 ± 0.37 0.27 complications, such as cognitive impairment.
POTENTIAL RISK FACTORS
Hypertension, diabetes mellitus, heart disease, dyslipidemia, smoking MCA, median (IQR) 1.11 (0.95-1.38) 1.09 (0.91-1.46) 0.54
PI = (peak systolic velocity - minimal diastolic velocity) / (mean velocity) References:
STATISTICAL ANALYSIS 1. Harris S et al. SAGE Open Med. 2018 4. Lau KK et al., Int J Stroke. 2018
• Trend: PI CCA>PI ICA>PI MCA 5. Kim JT et al., J Neurol Sci. 2011
SPSS 23 (Uni- & bivariate analysis, Spearman correlation, and multiple • Stronger correlation between PI of CCA and PI MCA in overall stroke (B 2. KimY et al.Yonsei Med J. 2016
regression). P value significant at <0.05. 3. de la Cruz-Cosme C et al., J Stroke 6. Harris S et al., Front Neurol. 2018
0.4, p 0.001), compared to PI of MCA and CCA (B 0.34, p = 0.005).
Cerebrovasc Dis. 2018