Document Detail


Failure of cerebral hemodynamic selection in general or of specific positron emission tomography methodology?: Carotid Occlusion Surgery Study (COSS).
MedLine Citation:
PMID:  21960571     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The Carotid Occlusion Surgery Study (COSS) was an improvement over the Extracranial-Intracranial Bypass Study, which did not utilize physiological selection. To assess possible reasons for early closure of the COSS trial, we reviewed COSS methods used to identify high-risk patients and compared results with separate quantitative data.
METHODS: Increased oxygen extraction fraction (OEF) by positron emission tomography is a gold standard for ischemia, but the specific thresholds and equivalency of the semiquantitative OEF ratio utilized in COSS and quantitative OEF are at issue.
RESULTS: The semiquantitative hemispheric OEF ratio used in COSS did not identify the same group of patients as did quantitative OEF using a threshold of 50%.
CONCLUSIONS: The failure of COSS is likely caused by a failure of the semiquantitative, hemispheric OEF ratio method rather than by the selection for bypass based on hemodynamic compromise.
Authors:
Andrew P Carlson; Howard Yonas; Yue-Fang Chang; Edwin M Nemoto
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-09-29
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-29     Completed Date:  2012-08-13     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3637-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of New Mexico, MSC 10 5615, Albuquerque, NM 87131, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain Ischemia / etiology*,  physiopathology,  radionuclide imaging
Carotid Stenosis / complications,  physiopathology,  radionuclide imaging,  therapy*
Humans
Positron-Emission Tomography
Randomized Controlled Trials as Topic
Risk Factors
Stroke / etiology*,  physiopathology,  radionuclide imaging
Grant Support
ID/Acronym/Agency:
NS051639/NS/NINDS NIH HHS; NS061216/NS/NINDS NIH HHS; R01 NS051639-01/NS/NINDS NIH HHS; R01 NS051639-02/NS/NINDS NIH HHS; R01 NS051639-03/NS/NINDS NIH HHS; R01 NS051639-04/NS/NINDS NIH HHS; R01 NS051639-05/NS/NINDS NIH HHS
Comments/Corrections

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