The significance of pulsatility indices in the middle cerebral, internal carotid, and common carotid arteries for small vessel disease in the brain: A retrospective cross-sectional study

Background and objectives. The pulsatility index (PI) indicates the resistance in distant blood vessels and the stiffness of major arteries outside the brain. For cerebral small vessel disease (CSVD), our aim is to enhance our comprehension of the Pulsatility Index (PI) in the common carotid artery (CCA), internal carotid artery (ICA), and middle cerebral artery (MCA). Materials and methods. This study is a cross-sectional retrospective research, which was conducted between January 2020 and June 2020 at the Dr. Cipto Mangunkusumo National Hospital, Indonesia. Patients were divided into groups with CSVD and without CSVD. Univariate and bivariate analyses, along with Spearman correlation and multivariate regression, were conducted to assess the mean difference. The overall score for CSVD was determined based on findings from brain MRI scans. Results. The median age of the 79 participants was 60 years (49-66). CSVD made up 54.4% of the total. The median (interquartile range) PI values for the CCA, ICA, and MCA in cases of CSVD were 1.48 (1.3-1.68), 1.12±0.3, and 1.11 (0.95-1.38), respectively. Despite this, no significant differences in PI were observed between the groups. In cases of total stroke, the PI of the CCA showed a moderate correlation with the PI of the MCA (B 0.4, p=0.001) and the PI of the ICA (B 0.34, p=0.005). However, no correlation was found between PI and either the burden of CSVD or the total score for small vessel disease. Conclusions. The pulsatility indices for the CCA, ICA, and MCA generally rise in cases of CSVD, indicating heightened resistance in distal blood vessels and increased stiffness in the large arteries outside the skull. This highlights the potential use of PI measurement as a promising adjunctive screening and evaluation tool in CSVD.