Interhemispheric asymmetry in brain perfusion before and after carotid stenting: a 99mTc-HMPAO SPECT study
| Autor: | Athanasios Dimitriadis, Christos D. Karkos, Charalampos Liasidis, Dimitrios Boundas, Georgios Arsos, Thomas S. Gerassimidis, Charalampos Spyridis, Giorgos S. Sfyroeras |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Perfusion scanning Amaurosis Fugax Single-photon emission computed tomography Asymptomatic Severity of Illness Index Brain Ischemia Blood Vessel Prosthesis Implantation Technetium Tc 99m Exametazime Carotid artery disease medicine Humans Radiology Nuclear Medicine and imaging Carotid Stenosis Cerebral perfusion pressure Aged Aged 80 and over Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Angiography Digital Subtraction Middle Aged medicine.disease Magnetic Resonance Imaging Stroke Stenosis Treatment Outcome Ischemic Attack Transient Cerebrovascular Circulation Linear Models Surgery Female Stents Radiology Carotid stenting medicine.symptom Radiopharmaceuticals Cardiology and Cardiovascular Medicine business Nuclear medicine Perfusion Angioplasty Balloon Follow-Up Studies |
| Zdroj: | Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 13(6) |
| ISSN: | 1526-6028 |
| Popis: | PURPOSE To assess the effect of unilateral carotid angioplasty and stenting (CAS) on cerebral perfusion asymmetry in patients with severe extracranial carotid stenosis by means of technetium Tc 99m hexamethyl-propyleneamine oxime brain single photon emission computed tomography ((99m)Tc-HMPAO SPECT). METHODS Twenty-nine consecutive patients (22 men; median age 68 years, range 58-80; 13 symptomatic) undergoing unilateral CAS were included in the study. Brain perfusion was assessed by (99m)Tc-HMPAO brain SPECT prior to the procedure and postoperatively at 8 hours and at 2 to 4 months. The asymmetry index (AI), a measure of the interhemispheric asymmetry in perfusion, was calculated as [(counts in "healthy" hemisphere-counts in hemisphere with carotid stenosis)/counts in "healthy" hemisphere]x100. RESULTS The preoperative AI demonstrated a wide variation (mean -0.5%+/-8.4%, range -19.5% to 14.1%). There was no significant correlation between the degree of carotid stenosis and preoperative AI. The mean preoperative AI in the asymptomatic patients was lower than in the symptomatic group [-4.0%+/-8.5% (range -19.5% to 8.2%) versus 3.8%+/-6.4% (range -5.2% to 14.1%), p=0.01], suggesting reduced perfusion of the ipsilateral cerebral hemisphere compared to the contralateral side in symptomatic patients. AI variation did not improve after CAS; there was no difference in AI among the 3 SPECT studies (p=0.75). Preoperative AI correlated significantly with late AI (r=0.74, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|