Acetazolamide SPECT scans in the evaluation of symptomatic and asymptomatic patients with carotid occlusive disease

Dolores F. Cikrit, Michael Dalsing, Harold M. Burkhart, Robert W. Burt, Stephen G. Lalka, Alan Sawchuk, Betty Solooki

Research output: Contribution to journalArticle

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Abstract

Acetazolamide (ACZ)-enhanced Single Photon Emission Computer Tomography (SPECT) scans can assess both cerebral perfusion and vascular reactivity. Patients with poor reactivity lack perfusion reserve, and are at risk for stroke should perfusion diminish further. This study compared the preoperative ACZ-enhanced SPECT scans of 60 symptomatic to 40 asymptomatic patients with internal carotid artery stenosis (ICAS) in an effort to better define the cause of their symptoms and effects of carotid endarterectomy (CEA) on cerebral perfusion and reactivity in these two groups of patients. Symptomatic patients had at least a 60% (x=84%) ICAS. Asymptomatic patients had at least an 80% (x=90%) ICAS. Preoperative ACZ SPECT scans were obtained usually one week before CEA. All patients underwent CEA. Postoperative ACZ SPECT scans were obtained in 78 of the patients, usually at the first postoperative (~30 days) visit. Asymptomatic patients demonstrated poorer perfusion than symptomatic patients, which tends to support the premise that most strokes and carotid symptoms are secondary to emboli rather than hypoperfusion. Interestingly, cerebral reactivity was poor in both symptomatic and asymptomatic patients before CEA, suggesting inadequate collaterals and dependency on the ipsilateral carotid. Carotid endarterectomy improved vasoreactivity in 84% of the patients. ACZ SPECT scans provided evidence of the return of cerebral perfusion and reactivity following endarterectomy.

Original languageEnglish
Pages (from-to)579-587
Number of pages9
JournalVascular Surgery
Volume33
Issue number6
StatePublished - Nov 1999

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Acetazolamide
Photons
Tomography
Carotid Endarterectomy
Perfusion
Carotid Stenosis
Stroke
Endarterectomy
Embolism
Blood Vessels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Acetazolamide SPECT scans in the evaluation of symptomatic and asymptomatic patients with carotid occlusive disease. / Cikrit, Dolores F.; Dalsing, Michael; Burkhart, Harold M.; Burt, Robert W.; Lalka, Stephen G.; Sawchuk, Alan; Solooki, Betty.

In: Vascular Surgery, Vol. 33, No. 6, 11.1999, p. 579-587.

Research output: Contribution to journalArticle

Cikrit, Dolores F. ; Dalsing, Michael ; Burkhart, Harold M. ; Burt, Robert W. ; Lalka, Stephen G. ; Sawchuk, Alan ; Solooki, Betty. / Acetazolamide SPECT scans in the evaluation of symptomatic and asymptomatic patients with carotid occlusive disease. In: Vascular Surgery. 1999 ; Vol. 33, No. 6. pp. 579-587.
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