Relief of Nonhemispheric Symptoms in Low Flow States by Anterior Circulation Revascularization: a Physiologic Approach.
Publication/Presentation Date
2-1-1987
Abstract
Operative intervention remains controversial for patients with transient nonhemispheric symptoms with occlusive disease of both the anterior and posterior cerebral circulations. In addition to the standard evaluation of these patients, we have used stable xenon-enhanced computed tomographic mapping of cerebral blood flow (Xe/CT CBF). This relatively new and potentially widely available CBF methodology, by measuring approximately 30,000 CBF values within each of three CT levels, provides a readily interpretable means of evaluating extremes of hemodynamic compromise within any or all vascular territories. In the past 30 months, Xe/CT CBF studies in 300 patients with occlusive vascular disease have identified nine patients with global low flow and nonhemispheric symptoms (vertigo, lightheadedness, and/or blurred vision). Blood pressures determined by ocular pneumoplethysmography of Gee were markedly abnormal with reduced ocular/brachial ratios. Each patient had a combination of both segmental carotid and vertebrobasilar occlusive disease. Each patient had a flow-augmenting procedure performed on the anterior circulation in an attempt to improve global flow: carotid endarterectomy (two patients), subclavian-external carotid bypass (one patient), and superficial temporal artery-middle cerebral artery bypass (six patients). In each case disabling transient symptoms were relieved. There were no operative deaths, but one stroke occurred, probably as a result of a brief period of postoperative hypotension. Postoperative Xe/CT CBF studies show a long-term improved global CBF in all patients.
Volume
5
Issue
2
First Page
289
Last Page
297
ISSN
0741-5214
Published In/Presented At
Yonas, H., Steed, D. L., Latchaw, R. E., Gur, D., Peitzman, A. B., & Webster, M. W. (1987). Relief of nonhemispheric symptoms in low flow states by anterior circulation revascularization: a physiologic approach. Journal Of Vascular Surgery, 5(2), 289-297.
Disciplines
Medical Sciences | Medicine and Health Sciences
PubMedID
3820402
LVHN link
http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=3820402&site=ehost-live&scope=site
Department(s)
Department of Medicine, Department of Medicine Faculty
Document Type
Article
Comments
Dr. William Gee MD is mentioned in this article.