HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Palestro, C. J. Articles by Goldsmith, S. J. Search for Related Content PubMed PubMed Citation Articles by Palestro, C. J. Articles by Goldsmith, S. J.

Assessing Collateral Cerebral Perfusion with Technetium-99m-HMPAO SPECT During Temporary Internal Carotid Artery Occlusion

Long Island Jewish Medical Center, New Hyde Park, New York
Mount Sinai Medical Center, New York, New York

Correspondence: For correspondence or reprints contact: Christopher J. Palestro, MD, Division of Nuclear Medicine, Long Island Jewish Medical Center, Lakeville Rd., New Hyde Park, NY 11042.

ABSTRACT

Cerebral infarction following internal carotid artery occlusion results from either embolism or inadequate collateral blood flow. Although risk of embolism can be minimized, detecting compromised collateral circulation is more difficult. Cerebral angiography, carotid stump pressures and clinical evaluation during internal carotid artery occlusion are of limited utility. Xenon-133 radionuclide studies and stable xenon computed tomography are not readily available. We evaluated ^99mTc-HMPAO SPECT, during temporary carotid artery occlusion, in 20 patients considered for internal carotid artery occlusion. Fourteen demonstrated symmetric cerebral perfusion during occlusion: eleven underwent transient and three had permanent carotid artery occlusion without complications. Five patients had ipsilateral globally decreased perfusion during temporary occlusion. One patient underwent transient occlusion of this vessel and one underwent carotid sacrifice without bypass grafting; both recovered without sequelae. The three remaining patients underwent carotid artery bypass grafting prior to sacrifice of this vessel. One patient with a small focal perfusion defect underwent carotid artery sacrifice without bypass grafting and developed acute neurologic deficits postoperatively. These initial results suggest that symmetric cerebral perfusion during temporary occlusion indicates that internal carotid artery occlusion will be tolerated. Although its implications are not yet well defined, the abnormal study identifies patients potentially at risk for postocclusion complications, thus providing a basis for neurosurgical management.

This article has been cited by other articles:

				Y. Sugawara, T. Kikuchi, T. Ueda, M. Nishizaki, S. Nakata, T. Mochizuki, and J. Ikezoe Usefulness of Brain SPECT to Evaluate Brain Tolerance and Hemodynamic Changes During Temporary Balloon Occlusion Test and After Permanent Carotid Occlusion J. Nucl. Med., December 1, 2002; 43(12): 1616 - 1623. [Abstract] [Full Text] [PDF]

				E. Michel, H. Liu, K. B. Remley, A. J. Martin, M. T. Madison, J. Kucharczyk, and C. L. Truwit Perfusion MR Neuroimaging in Patients Undergoing Balloon Test Occlusion of the Internal Carotid Artery AJNR Am. J. Neuroradiol., September 1, 2001; 22(8): 1590 - 1596. [Abstract] [Full Text] [PDF]

				M. Kaminogo, M. Ochi, M. Onizuka, H. Takahata, and S. Shibata An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion Stroke, February 1, 1999; 30(2): 407 - 413. [Abstract] [Full Text] [PDF]