• M Aleksic and J Brunkwall.
• Department of Vascular Surgery, University Clinic of Cologne, Cologne, Germany. aleksicm@kliniken-koeln.de
• Eur J Vasc Endovasc Surg. 2009 Nov 1;38(5):552-5.

ObjectiveThe collateral function of the external carotid artery (ECA) for cerebral perfusion in cases of atherosclerotic occlusive disease of the internal carotid artery (ICA) is difficult to assess; for this reason, blood flow measurements were taken during carotid endarterectomy (CEA).MethodsBlood flow was measured before and after CEA using a transit-time flow meter at the carotid artery in 1000 patients who underwent CEA for high-degree (>70%) ICA stenosis. The data were collected prospectively and analysed retrospectively.ResultsMedian ICA blood flow increased significantly, up 46% from 160 ml min(-1) (IQR: 100-234 ml min(-1)) before CEA to 240 ml min(-1) (IQR: 187-309 ml min(1)) after CEA (P<0.001). Median ECA blood flow dropped by 4%, from 152 ml min(-1) (IQR: 108-220 ml min(-1)) to 150 ml min(-1) (IQR: 103-200 ml min(-1)) (P=0.001). Relative ICA blood flow volumes related to common carotid artery (CCA) flow increased from 58% before CEA to 73% after CEA, whereas relative ECA flow decreased from 54% to 44%.ConclusionsIncreased blood flow in the ICA after CEA is accompanied by decreased ECA flow whereupon the absolute amount of this redistribution is relatively limited. A more profound evaluation of these haemodynamic conditions demands further study.

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