Acetazolamide enhanced single photon emission computed tomography (SPECT) evaluation of cerebral perfusion before and after carotid endarterectomy

Dolores F. Cikrit, Robert W. Burt, Michael Dalsing, Stephen G. Lalka, Alan Sawchuk, Bonnie Waymire, Robert M. Witt

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Twenty-five patients were tested before and after carotid endarterectomy with resting and acetazolamide enhanced single photon emission computed tomography (SPECT) scans with hexamethyl propyleneamine oxine (HMPAO) or iofetamine hydrochloride I123 (123I labeled IMP), both widely available radiopharmaceuticals. Twenty preoperative SPECT studies were asymmetric, revealing focal or diffuse decreased perfusion reserve, and 13 also demonstrated infarcts. Five patients had symmetric (normal) studies. After carotid endarterectomy, 22 cases had changed flow distribution patterns. Usually improvement of reactivity ipsilateral occurred to the area operated on. In four, contralateral improvement was also found. Three of the patients who had preoperative symmetrical scans had increased ipsilateral reactivity after surgery indicating previous global loss of reactivity. Acetazolamide SPECT scans demonstrate a decreased perfusion reserve in 20 patients with carotid artery stenosis, indicating reduced perfusion and poor collateral circulation. Postoperative studies confirm improvement by demonstrating recovery of vascular reactivity in 84% of the patients. Acetazolamide enhanced SPECT scans may be helpful in providing objective evidence for selection of patients for carotid endarterectomy, especially in those who have an 80% carotid artery stenosis, but are asymptomatic.

Original languageEnglish
Pages (from-to)747-754
Number of pages8
JournalJournal of Vascular Surgery
Volume15
Issue number5
DOIs
StatePublished - 1992

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Acetazolamide
Carotid Endarterectomy
Single-Photon Emission-Computed Tomography
Perfusion
Carotid Stenosis
Iofetamine
Oxyquinoline
Inosine Monophosphate
Collateral Circulation
Radiopharmaceuticals
Patient Selection
Blood Vessels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Acetazolamide enhanced single photon emission computed tomography (SPECT) evaluation of cerebral perfusion before and after carotid endarterectomy. / Cikrit, Dolores F.; Burt, Robert W.; Dalsing, Michael; Lalka, Stephen G.; Sawchuk, Alan; Waymire, Bonnie; Witt, Robert M.

In: Journal of Vascular Surgery, Vol. 15, No. 5, 1992, p. 747-754.

Research output: Contribution to journalArticle

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