Hemodynamic Steal in Patients with Symptomatic Internal Carotid Artery Stenosis and Occlusion

Reinoud PH Bokkers¹, Nolan S. Hartkamp¹, Esben T. Petersen¹, Catharina JM Klijn², Bart van der Worp², Jeroen Hendrikse¹

Cerebrovascular reactivity (CVR) is the compensatory ability of the brain to sustain blood flow when there are fluctuations in cerebral perfusion pressure through vasodilatation of the cerebral vasculature. Negative CVR, also known as hemodynamic steal, occurs when arterial blood is redistributed from regions of exhausted cerebrovascular capacity to areas with preserved vasodilatory capacity (2). The aim of our study was to investigate the occurrence and extent of hemodynamic steal in patients with a carotid artery stenosis by combining ASL perfusion imaging with a vascular challenge.