Effect of pre-surgery assessments on the prognosis of patients received extracranial-intracranial bypass surgery

Autor: Fuguang Hu, Chen Li, Liqun Wang, Xiao-Feng Sun, Zhizhao Ma, Xu-hua Cao
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Ischemia
Single-photon emission computed tomography
Severity of Illness Index
Brain Ischemia
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Developmental Neuroscience
Modified Rankin Scale
Preoperative Care
medicine
Humans
030212 general & internal medicine
Stroke
Aged
Transient ischemic attack (TIA)
Blood Volume
Cerebral Revascularization
medicine.diagnostic_test
business.industry
Incidence
Brain
Prognosis
medicine.disease
Survival Analysis
Surgery
Neurology
Bypass surgery
Cerebral blood flow
Positron emission tomography
Cerebrovascular Circulation
Positron-Emission Tomography
Female
Neurology (clinical)
Tomography
X-Ray Computed
business
030217 neurology & neurosurgery
Follow-Up Studies
circulatory and respiratory physiology
Zdroj: Restorative Neurology and Neuroscience. 36:593-604
ISSN: 1878-3627
0922-6028
Popis: Background Extracranial-intracranial (EC-IC) bypass surgery has been used to improve the conditions of cerebral ischemia symptoms for selected patients resulting from diverse complications such as stroke and atherosclerotic disease. However, several clinical trials showed EC-IC bypass surgery failed to prevent recurrent ischemic stroke in certain patients. Objective Our clinical trial aimed to investigate whether there is a correlation between pre-surgery assessments and prognosis of patients received EC-IC bypass operation. Methods We divided all patients into 4 groups according to their compensatory stages of cerebral ischemia. The values of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and oxygen extraction fraction (OEF) were obtained by computed tomography perfusion (CTP), single photon emission computed tomography (SPECT), and positron emission tomography (PET) at different time points before and after EC-IC bypass surgery. We assessed the correlations between the compensatory stage with modified Rankin scale (mRS) scores, survival rates, stroke and TIA incidences over the 12 months after surgery. Results Patients with normal CBF, normal or increased CBV, and normal OEF tended to have a better prognosis after the EI-CI bypass operation than patients with abnormal CBF, CBV and OEF. However, patients with abnormal CBF and CBV, and increased OEF showed elevated mRS, less survival rates, and higher stroke and TIA incidences over the 12 months after surgery, compared to the groups with normal CBF, CBV and OEF. Conclusions Our results suggest that a defined compensatory stage of cerebral ischemia might be useful for the prognosis of patients receiving EI-CI bypass surgery.
Databáze: OpenAIRE
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