Improved cerebrovascular reactivity following low flow EC/IC bypass in patients with occlusive carotid disease

• Published in: British journal of neurosurgery 2010-04, Vol.24 (2), p.179-184
• Main Authors: Patel, Hiren C., Mcnamara, Iain R., Al-Rawi, Pippa G., Kirkpatrick, Peter J.
• Format: Article
• Language: English
• Subjects: Acetazolamide - pharmacology; Adult; Aged; Analysis of Variance; Blood Flow Velocity; Blood vessels; Brain; Brain - blood supply; Carotid Artery Diseases - surgery; Carotid Artery, Internal - surgery; carotid occlusion; cerebral blood flow; Cerebral Revascularization - methods; Cerebrovascular Circulation - drug effects; cerebrovascular reactivity; EC/IC bypass; Humans; Middle Aged; Morbidity; Mortality; Neurosurgery; Patients; Risk Factors; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome; Variance analysis; Xenon; Xenon CT scanning; Young Adult
• ISSN: 0268-8697; 1360-046X
• DOI: 10.3109/02688690903536603

Patients with major cerebral artery occlusive disease can suffer cerebral hypoperfusion and be at an increased risk of future strokes. EC/IC bypass has been shown to reduce this risk. Patients with cerebral hypoperfusion, and who are at risk of haemodynamic ischaemia, can be identified by the use of xenon computerised tomography (XeCT) to demonstrate severe impairment of the cerebrovascular reserve (CVR). We report our series on the effect of low flow EC/IC bypass on CVR in patients with symptomatic cerebral haemodynamic ischaemia. Thirteen patients with clinical and radiological features of cerebral hypoperfusion were assessed with acetazolamide activated XeCT. Pre- and postoperative regional cerebral blood flow (rCBF) and CVR were assessed. The change in CVR from pre- to post surgery was calculated (%CVR). Values were compared using ANOVA and Student's paired t-test. Unless otherwise stated, values are given as mean ± standard error of the mean. Statistical significance was taken at p