Impaired cerebral autoregulation in asymptomatic patients with carotid artery stenosis: comparison of acetazolamide-SPECT and transcranial CO(2)-dopplersonography

Zentralblatt für Chirurgie
M EngelhardtK D Wölfle

Abstract

The indication for operation in patients with asymptomatic high-grade carotid artery stenosis is still under debate. Since impaired cerebrovascular autoregulation is associated with an increased risk for ischaemic events, assessment of cerebral vascular reactivity might be a valuable selection criterion for surgery. The aim of our study was therefore to evaluate the incidence of impaired autoregulation in asymptomatic patients with acetazolamide-single photon emission computed tomography (ACZ-SPECT) and transcranial CO (2)-dopplersonography (CO (2)-TCD). Furthermore, both methods were compared in regard to results and clinical practicability. In 42 patients with high-grade (> 70 %) asymptomatic carotid artery stenosis, cerebral perfusion and vascular reactivity were assessed with resting and ACZ-enhanced SPECT scans. In 31 of these patients the CO (2) reactivity of cerebral perfusion was determined by TCD and expressed as normalized autoregulation reserve (NAR). Cerebral perfusion was decreased in 14.3 %. In ACZ-SPECT 26 % and in CO (2)-TCD 28 % revealed an impaired vascular reactivity. Conformity of both methods was high (kappa = 0.93). TCD was superior in practicability, but only applicable in 81 % due to a missing temporal b...Continue Reading

Citations

Apr 29, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Anna NocuńBeata Chrapko
Mar 14, 2013·Expert Opinion on Medical Diagnostics·Chrysi BogiatziJ David Spence
Aug 19, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Gregory TelmanDavid Yarnitsky
Apr 11, 2012·Clinical Physiology and Functional Imaging·Helene ZachrissonReinhard Volkmann
Jan 29, 2021·Case Reports in Neurology·Narayanaswamy VenketasubramanianManish Taneja

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.