Balloon Test Occlusion of the Carotid Artery: Internal Validation of Predictive Results
| Autor: | Yusuke Nishikawa, Hiroyuki Katano, Hiroshi Yamada, Noritaka Aihara, Mitsuhito Mase, Takeshi Torigai, Teishiki Shibata, Takumi Kitamura |
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| Rok vydání: | 2021 |
| Předmět: |
Tomography
Emission-Computed Single-Photon medicine.medical_specialty medicine.diagnostic_test Cerebral infarction business.industry Cerebral Infarction Balloon Occlusion medicine.disease Cerebral blood flow Tolerability Balloon test occlusion Internal medicine Carotid artery.internal Cerebrovascular Circulation medicine Cardiology Humans Surgery Neurology (clinical) Derivation business Perfusion Emission computed tomography Carotid Artery Internal |
| Zdroj: | Turkish neurosurgery. 31(5) |
| ISSN: | 1019-5149 |
| Popis: | Aim In balloon test occlusion (BTO) of the carotid artery, the measurement procedures used for cerebral blood flow (CBF), such as single-photon emission computed tomography (SPECT), have been reported to be particularly useful. However, they are complicated and expensive. We attempted to develop a protocol of BTO to perform SPECT only in cases that require it by using mean stump pressure (MSTP) and aimed to internally validate the accuracy and reliability of this protocol. Material and methods BTO was performed in 52 consecutive patients (derivation group). Using the derivation group data, a protocol was created and applied to 55 consecutive patients (validation group). Results In the derivation group, all patients with MSTP ≥65 mmHg had an ischemic tolerance, whereas those with MSTP ≤45 mmHg were considered ischemic intolerant. Based on these results, we developed a protocol wherein MSTP between 45 mmHg and 65 mmHg was defined as "ischemic borderzone" and SPECT was performed in all these cases. Using this protocol, BTO was performed in the validation group and 19 patients were treated with parent artery occlusion with or without bypass. In two cases that did not follow the protocol, the occurrence of hypoperfusion caused cerebral infarction after treatment. However, if this protocol had been followed for all cases, no false-negative cases of BTO would have occurred. Conclusion By measuring MSTP and identifying the approximate ischemic tolerability, the current protocol can identify cases requiring SPECT, which is particularly reliable but complicated. Moreover, this protocol would be especially useful for reducing false-negative cases of BTO. |
| Databáze: | OpenAIRE |
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