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Brain Blood Flow SPECT in Temporary Balloon Occlusion of Carotid and Intracerebral Arteries

Department of Radiology, Division of Nuclear Medicine, Division of Neuroradiology, Department of Neurological Surgery and Nuclear Medicine Center, The University of Texas Southwestern Medical Center, Dallas, Texas

Correspondence: For correspondence or reprints contact Dana Mathews, PhD, MD, The University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9071.

ABSTRACT

It is important to determine preoperatively which patients can tolerate permanent occlusion of a cervical internal carotid or cerebral artery when such a procedure may be necessary to treat cerebrovascular or neoplastic lesions. Here we report our experience in combining temporary intra-arterial balloon occlusion with concomitant cerebral blood flow imaging in preoperative evaluation of such patients. Forty-two patients with a variety of cerebrovascular and neoplastic lesions underwent trial balloon occlusion of an internal carotid or intracerebral artery. Eight patients developed both neurologic symptoms as well as brain perfusion defects during trial occlusion. Nine others developed only perfusion defects. The remainder were asymptomatic and had negative scans. Brain blood flow imaging during intra-arterial balloon occlusion identified 17 patients potentially at risk for developing postsurgical ischemic deficits. Treatment alternatives to acute arterial sacrifice were developed for these patients.

FOOTNOTES

^* Present address: Dept. of Diagnostic Radiology, The University of Kansas Medical Center, Kansas City, KS.

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