Abstract
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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Clifton GL, Haden HT, Taylor JR, Sobel M (1988) Cerebrovascular C02 reactivity after carotid artery occlusion. J Neurosurg 69:24–28
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 313:1191–1200
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] 16:334
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 17–36
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] 1:442
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 6:226–230
Rüssel D, Dybevold S, Kjartansson O, Nyberg-Hansen R, Rootwelt K, Wiberg J (1990) Cerebral vasoreactivity and blood flow before and 3 months after carotid endarterectomy. Stroke 21:1029–1032
Schroeder T (1986) Cerebrovascular reactivity to acetazolamide in carotid artery disease. Neurol Res 8:231–236
Schroeder T, Sillesen H, Sorensen O, Engell HC (1987) Cerebral hyperperfusion following carotid endarterectomy. J Neurosurg 66:824–829
Sillesen H, Schroeder T, Buchardt Hansen HJ (1988) Haemodynamic evaluation of the cerebral circülation by periorbital Doppler examination and cerebral blood flow (CBF) measurement in carotid artery disease. Neurol Res 10:57–60
Sullivan HG, Kingsbury TB, Morgan ME, Jeffcoat RD, Allison JD, Goode JJ, McDonnel DE (1987) The rCBF response to Diamox in normal subjects and cerebrovascular disease patients. J Neurosurg 67:525–534
Vorstrup S, Brun B, Lassen NA (1986) Evaluation of the cerebral vasodilatory capacity by the acetazolamide test before EC-IC bypass surgery in patients with occlusion of the internal carotid artery. Stroke 17:1291–1298
Zeiger HE, Zampella EJ, Naftel DC, McKay RD, Varner PD, Morawetz RB (1987) A prospective analysis of 142 carotid endarterectomies for occlusive vascular disease. J Neurosurg 67:540–544
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer-Verlag, Berlin Heidelberg
About this paper
Cite this paper
Rem, J.A., Gratzl, O., Müller, H.R., Müller-Brand, J., Radü, E.W. (1992). Changes in CBF After Carotid Endarterectomy: Follow-up in Neurologically Asymptomatic Patients. In: Schmiedek, P., Einhäupl, K., Kirsch, CM. (eds) Stimulated Cerebral Blood Flow. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77102-6_25
Download citation
DOI: https://doi.org/10.1007/978-3-642-77102-6_25
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-77104-0
Online ISBN: 978-3-642-77102-6
eBook Packages: Springer Book Archive