Changes in CBF After Carotid Endarterectomy: Follow-up in Neurologically Asymptomatic Patients
According to a previous report (EC/IC Bypass Study Group 1985), patients with high- grade stenoses or occlusions of cerebral arteries, who were expected to benefit from surgical procedures, did not actually benefit clinically. We tried to define a subgroup in neurologieally asymptomatic patients by two quantiative methods, namely regional cerebral blood flow (CBF) and ultrasonic common carotid flow (CCF) measurements. Mean hemispheric CBF was measured at rest and after administration of 1 g acetazolamide (Diamox). Several authors demonstrated that the acetazolamide test is a reliable indicator of critically reduced cerebral perfusion pressure (Schroeder 1986; Sillesen et al. 1988) and may unmask perfusion deficits even in patients with normal baseline values (Vorstrup et al. 1986; Sullivan et al. 1987). In this report we compare the preoperative and postoperative CBF and CCF values and discuss the significance of prophylactic carotid endarterectomy.
KeywordsCerebral Blood Flow Cerebral Perfusion Pressure Carotid Endarterectomy Carotid Stenosis Carotid Artery Disease
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