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.
KeywordsNeurol Xenon Acetazolamide Cerebro Diamox
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- EC/IC Bypass Study Group (1985) Failure of extra-intracranial arterial bypass to reduce the risk of ischemic stroke: results of an international randomized trial. N Engl J Med 313:1191–1200Google Scholar
- Furahata H, Kanno R, Kodaira K, Aoyagi T, Hayashi J, Matsumodo H, Joshimura S (1978) An ultrasonic blood flow measuring system to detect absolute volume flow. Iyodenshi To Seitai Kogaku [Suppl] 16:334Google Scholar
- Müller HR, Radü EW, Gratzl O (1984) Common carotid cw Doppler flow measurement in neurovascular surgery. In: Kurjak A, Kossoff G (eds) Recent advances in ultrasound diagnosis, vol 4. Elsevier, Amsterdam, pp 17–36Google Scholar
- Müller HR, Buser M, Müller J, Schneider T (1985) Correlation of mean hemispheric blood flow by Xenon 133 clearance to common carotid flow by QFM Doppler in 100 patients. Ultrasound Med Biol [Suppl] 1:442Google Scholar
- Rosenthal D, Ruddermann R, Borrero E, Hafner DH, Perdue GD, Lamis PA, Clark MD, Daniel WW (1987) Carotid endarterectomy to correct asymptomatic carotid stenosis: ten years later. J Vase Surg 6:226–230Google Scholar