Decreased Cerebral Perfusion in Carotid Artery Stenosis, Carotid Angioplasty and Its Effects on Cerebral Circulation

Two major mechanisms are involved in cerebral ischemia (Mohr et al., 1997). Cerebral perfusion failure may occur as the result of flow reduction mediated by stenosis or occlusive vascular damage such as that arising from atheroma plaques that affect the carotid bulb. Perfusion failure affects the distal territories, and it is known as a watershed infarction. The second mechanism of cerebral ischemia is artery-to-artery embolism, which is considered to be the main cause of ischemia associated with plaques in the larger arteries. There are thrombosis in situ and embolic infarctions associated with these plaques, which usually involve the occlusion of intracranial distal vessels.