Prediction of Need for Carotid Shunting During Carotid Endarterectomy by Clinical Risk Factors, rCBF, and rCVR on ACZ-SPECT
| Predictor of carotid shunting | No. of carotid shunts (%) | Fisher's exact test | Crude odds ratio | Logistic regression | |
|---|---|---|---|---|---|
| Odds ratio | P | ||||
| Age (y) | |||||
| <59 (n = 21) | 2 (9.5) | NS | 2.7 | 4.3 | NS |
| ≥60 (n = 54) | 12 (22.2) | ||||
| Sex | |||||
| Female (n = 12) | 1 (8.3) | NS | 2.9 | 0.9 | NS |
| Male (n = 63) | 13 (20.6) | ||||
| Minor stroke or TIA | |||||
| No (n = 12) | 2 (16.7) | NS | 1.2 | 0.4 | NS |
| Yes (n = 63) | 12 (19.0) | ||||
| Diabetes mellitus | |||||
| No (n = 42) | 6 (14.3) | NS | 1.9 | 2.3 | NS |
| Yes (n = 33) | 8 (24.2) | ||||
| Hypertension | |||||
| No (n = 17) | 3 (17.6) | NS | 1.1 | 0.5 | NS |
| Yes (n = 58) | 11 (20.0) | ||||
| Smoking | |||||
| No (n = 30) | 4 (13.3) | NS | 1.9 | 1.7 | NS |
| Yes (n = 45) | 10 (22.2) | ||||
| Contralateral ICA stenosis (%) | |||||
| <70 (n = 54) | 7 (13.0) | P = 0.054 | 3.4 | 2.2 | NS |
| ≥70 (n = 21) | 7 (33.3) | ||||
| rCBF | |||||
| Normal (n = 34) | 5 (14.7) | NS | 1.6 | 1.5 | NS |
| Reduced* (n = 41) | 9 (22.0) | ||||
| rCVR | |||||
| Normal (n = 45) | 3 (6.7) | P < 0.01 | 8.1 | 13.5 | <0.01 |
| Reduced† (n = 30) | 11 (36.7) | ||||
| Mild‡ (n = 22) | 3 (13.6) | ||||
| Severe§ (n = 8) | 8 (100) | ||||
↵* <60% of normal deep ipsilateral cerebellar activity over one third of territory of middle cerebral artery on basal SPECT image.
↵† Abnormal cerebral perfusion that fell into even lower color range from basal SPECT after ACZ administration over at least one third of territory of middle cerebral artery.
↵‡ One color range from basal SPECT after ACZ administration (10%–20% change).
↵§ At least 2 color ranges after ACZ administration (>20% change).
NS = not significant (P > 0.1).