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22 September 2016 : Clinical Research  

Intraoperative Perfusion Computed Tomography in Carotid Endarterectomy: Initial Experience in 16 Cases

Zhe XueBC, Dingwei PengCD, Zhenghui SunABCD, Chen WuDE, Bainan XuEF, Fuyu WangFG, Dingbiao ZhouAD, Tianxiang DongBF

DOI: 10.12659/MSM.897356

Med Sci Monit 2016; 22:3362-3369

Abstract

BACKGROUND: This study aimed to evaluate the changes in perfusion computed tomography (PCT) parameters in carotid endarterectomy (CEA), and to discuss the use of intraoperative PCT in CEA.

MATERIAL AND METHODS: Sixteen patients with carotid stenosis who also underwent CEA with intraoperative CT were recruited in this study. We calculated quantitative data on cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and the relative parameter values, including relative CBF (rCBF), relative CBV (rCBV), and relative TTP (rTTP). The role of PCT was assessed and compared to conventional monitoring methods.

RESULTS: There were no significant differences in any of the parameters in the anterior cerebral artery (ACA) territory (P>0.05). In the middle cerebral artery (MCA) territory, the CBF and CBV increased and TTP decreased in the operated side during CEA; the rCBF and rCBV increased and the rTTP decreased significantly (P<0.05). In 16 patients, CT parameters were improved, SSEP was normal, and MDU was abnormal. In 3 patients, CBF increased by more than 70% during CEA. Relative PCT parameters are sensitive indicators for detecting early cerebral hemodynamic changes during CEA. Cerebral hemodynamics changed significantly in the MCA territory during CEA.

CONCLUSIONS: Intraoperative PCT could be an important adjuvant monitoring method in CEA.

Keywords: Acanthaceae, esophageal pH monitoring, Intraoperative Awareness

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750