| Cerebral ischemia during carotid artery cross-clamping: predictive value of phase-contrast magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 17086483 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The goal of this prospective study was to determine the utility of preoperative cerebral magnetic resonance imaging (MRI) in predicting cerebral ischemia during carotid artery cross-clamping for endarterectomy. Between January 2000 and December 2003, a total of 121 patients (95 men, 26 women) underwent three-dimensional phase-contrast MRI to assess collateral function prior to carotid endarterectomy. During regional anesthesia, patients were monitored to detect ischemic events and their timing in relation to cross-clamping and to determine mean intraoperative arterial pressure. These findings were then correlated with the collateral variations observed in the circle of Willis on preoperative MRI. Patients were classified into three groups according to neurological tolerance: normal tolerance (n = 106), immediate severe deficit (n = 9), and late deficit associated with arterial hypotension (n = 6). In the second group, a significant correlation was found between the absence of collateral circulation and neurological deficit (p < .0001). These results indicated that three-dimensional phase-contrast MRI is useful for predicting cerebral ischemia during carotid cross-clamping and selecting indications for shunting. Absence of visible collaterals of the circle of Willis on MRI is significantly predictive of early ischemia and an indication for systematic shunt placement. |
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Authors:
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Patrick Bagan; Renaud Vidal; Emmanuel Martinod; Marie-Dominique Destable; Bruno Tremblay; Jean Luc Dumas; Jacques F Azorin |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 20 ISSN: 0890-5096 ISO Abbreviation: Ann Vasc Surg Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-12-15 Completed Date: 2007-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 747-52 Citation Subset: IM |
Affiliation:
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Service de Chirurgie, Thoracique et Vasculaire, Avicenne University Hospital Center, Bobigny, France. patrick.bagan@egp.ap-hop-paris.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Blood Pressure Brain Ischemia / etiology* Carotid Artery Diseases / physiopathology*, surgery Cerebral Angiography / methods* Cerebrovascular Circulation* Circle of Willis / physiopathology Collateral Circulation Constriction Endarterectomy, Carotid / adverse effects*, methods Female Humans Image Interpretation, Computer-Assisted Imaging, Three-Dimensional Magnetic Resonance Angiography / methods* Male Middle Aged Nervous System Diseases / etiology Predictive Value of Tests Preoperative Care / methods* Prospective Studies Risk Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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