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Evaluating brain tolerability to carotid artery occlusion
Jun Zhong1, Meixiu Ding, Qing Mao
1Department of Neurosurgery, XinHua Hospital, Shanghai Second Medical University, Shanghai, 200092, People's Republic of China. jimzhong67@hotmail.com
Neurological Research
|February 5, 2003
Summary
This study introduces a balloon occlusion test (BOT) using SPECT to assess brain tolerance to carotid artery occlusion. The test effectively identifies patients at risk, ensuring safer carotid artery procedures.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Evaluating brain tolerance to carotid artery occlusion is crucial for patient safety.
- Permanent carotid artery occlusion may be necessary for various conditions.
- Objective methods are needed to predict tolerance before irreversible procedures.
Observation:
- A novel method using balloon occlusion test (BOT) with SPECT and DSA was applied to 10 patients.
- SPECT data was semi-quantitatively analyzed using a relative symmetry index (rS).
- Clinical neurological evaluation was performed throughout the procedure.
Findings:
- One patient failed the 45-min BOT with an rS of 74.5%, despite adequate collateral circulation.
- The remaining nine patients passed the BOT without neurological deficits, showing an rS of 97.8% +/- 4.4%.
- The BOT results guided subsequent surgical decisions, including carotid artery excision, reconstruction, or preservation.
Implications:
- This BOT technique can detect clinically silent hypoperfusion areas in the brain.
- It serves as a reliable preparatory assessment for carotid artery manipulations.
- Routine implementation of this BOT could significantly reduce neurological complications from carotid procedures.