Cerebral vascular reactivity assessed with acetazolamide single photon emission computer tomography scans before and after carotid endarterectomy

Dolores F. Cikrit, Michael Dalsing, Pamela S. Harting, Robert W. Burt, Stephen G. Lalka, Alan Sawchuk, Betty Solooki

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND METHODS: In 64 patients cerebral perfusion and vascular reactivity were assessed before and after carotid endarterectomy (CEA) using acetazolamide (ACZ)-enhanced single photon emission computer tomography (SPECT). Twenty-five patients were asymptomatic, whereas the remainder were symptomatic. Sixty-one patients had a ≤70% ipsilateral internal carotid artery stenosis. RESULTS: Fifty SPECT scans revealed decreased vascular reactivity. Twenty-three showed infarcts. Fourteen patients had normal studies. Twenty of the SPECT scans of asymptomatic patients demonstrated poor vascular reactivity. After CEA, 39 patients had improved ipsilateral vasoreactivity. In 12 patients, contralateral improvement was also found. CONCLUSION: ACZ-enhanced SPECT scans, by assessing cerebral perfusion and vascular reactivity, may help to identify patients at risk of stroke should perfusion further diminish. Postoperative studies confirm improvement in vascular reactivity. ACZ-enhanced SPECT scans may provide objective evidence for the selection of patients with a high-grade asymptomatic carotid stenosis for CEA.

Original languageEnglish
Pages (from-to)193-197
Number of pages5
JournalAmerican Journal of Surgery
Volume174
Issue number2
DOIs
StatePublished - Aug 1997

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Acetazolamide
Carotid Endarterectomy
Photons
Blood Vessels
Tomography
Perfusion
Carotid Stenosis
Patient Selection
Stroke

ASJC Scopus subject areas

  • Surgery

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Cerebral vascular reactivity assessed with acetazolamide single photon emission computer tomography scans before and after carotid endarterectomy. / Cikrit, Dolores F.; Dalsing, Michael; Harting, Pamela S.; Burt, Robert W.; Lalka, Stephen G.; Sawchuk, Alan; Solooki, Betty.

In: American Journal of Surgery, Vol. 174, No. 2, 08.1997, p. 193-197.

Research output: Contribution to journalArticle

Cikrit, Dolores F. ; Dalsing, Michael ; Harting, Pamela S. ; Burt, Robert W. ; Lalka, Stephen G. ; Sawchuk, Alan ; Solooki, Betty. / Cerebral vascular reactivity assessed with acetazolamide single photon emission computer tomography scans before and after carotid endarterectomy. In: American Journal of Surgery. 1997 ; Vol. 174, No. 2. pp. 193-197.
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AU - Cikrit, Dolores F.

AU - Dalsing, Michael

AU - Harting, Pamela S.

AU - Burt, Robert W.

AU - Lalka, Stephen G.

AU - Sawchuk, Alan

AU - Solooki, Betty

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N2 - BACKGROUND AND METHODS: In 64 patients cerebral perfusion and vascular reactivity were assessed before and after carotid endarterectomy (CEA) using acetazolamide (ACZ)-enhanced single photon emission computer tomography (SPECT). Twenty-five patients were asymptomatic, whereas the remainder were symptomatic. Sixty-one patients had a ≤70% ipsilateral internal carotid artery stenosis. RESULTS: Fifty SPECT scans revealed decreased vascular reactivity. Twenty-three showed infarcts. Fourteen patients had normal studies. Twenty of the SPECT scans of asymptomatic patients demonstrated poor vascular reactivity. After CEA, 39 patients had improved ipsilateral vasoreactivity. In 12 patients, contralateral improvement was also found. CONCLUSION: ACZ-enhanced SPECT scans, by assessing cerebral perfusion and vascular reactivity, may help to identify patients at risk of stroke should perfusion further diminish. Postoperative studies confirm improvement in vascular reactivity. ACZ-enhanced SPECT scans may provide objective evidence for the selection of patients with a high-grade asymptomatic carotid stenosis for CEA.

AB - BACKGROUND AND METHODS: In 64 patients cerebral perfusion and vascular reactivity were assessed before and after carotid endarterectomy (CEA) using acetazolamide (ACZ)-enhanced single photon emission computer tomography (SPECT). Twenty-five patients were asymptomatic, whereas the remainder were symptomatic. Sixty-one patients had a ≤70% ipsilateral internal carotid artery stenosis. RESULTS: Fifty SPECT scans revealed decreased vascular reactivity. Twenty-three showed infarcts. Fourteen patients had normal studies. Twenty of the SPECT scans of asymptomatic patients demonstrated poor vascular reactivity. After CEA, 39 patients had improved ipsilateral vasoreactivity. In 12 patients, contralateral improvement was also found. CONCLUSION: ACZ-enhanced SPECT scans, by assessing cerebral perfusion and vascular reactivity, may help to identify patients at risk of stroke should perfusion further diminish. Postoperative studies confirm improvement in vascular reactivity. ACZ-enhanced SPECT scans may provide objective evidence for the selection of patients with a high-grade asymptomatic carotid stenosis for CEA.

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