Multimodaler Karotisokklusionstest zur Bestimmung des Infarktrisikos vor therapeutischem Karotis-interna-Verschluß

Keller, E.; Ries, F.; Grünwald, Frank; Honisch, C; Rosanowski, F.; Pajor, László; Herberhold, C.; Solymosi, L.

doi:10.1055/s-2007-997745

Cited by 15 publications

(4 citation statements)

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“…Temporary occlusion of the ICA under different conditions [4, 5, 6, 7, 8, 9, 10, 11, 12](hypotension, Xenon-enhanced CT, provocation with Diamox and others) has been performed in order to find the safest method for predicting the risk of hemodynamic ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…Monitoring of the MCA Doppler shift with TCD under balloon occlusion of the ICA combines the advantages of both methods [9, 10, 11, 12, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…Because quantitative data on the reduction of cerebral blood flow (CBF) during balloon occlusion were not available, several studies with (semi)quantitative CBF measurements have been performed using 99m Tc-HMPAO SPECT imaging or Xenon-CT [4, 5, 6, 7, 8, 9, 10, 11, 12]. Changes in CBF during balloon occlusion were correlated with clinical tolerance but not with the collateral capacity of the communicating arteries shown by angiography or transcranial Doppler sonography (TCD).…”

Section: Introductionmentioning

confidence: 99%

“…Changes in CBF during balloon occlusion were correlated with clinical tolerance but not with the collateral capacity of the communicating arteries shown by angiography or transcranial Doppler sonography (TCD). Additionally TCD was used to measure the hemodynamic changes at the level of the basal arteries during balloon occlusion [10, 11, 12, 13, 14]. Carotid compression tests provide a functional assessment of the capacity of the circle of Willis as shown first by Padayachee et al [15]in 1986.…”

Section: Introductionmentioning

confidence: 99%

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The Carotid Compression Test for Therapeutic Occlusion of the Internal Carotid Artery

Hetzel

Reutern²,

Wernz

et al. 2000

Cerebrovasc Dis

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Background: The anterior communicating artery is a key collateral pathway in patients with internal carotid artery (ICA) occlusions. Diagnostic balloon or manual occlusion of the ICA is a qualified test for the collateral function of the circle of Willis. The aim of our study was to test whether transcranial Doppler sonography (TCD) with manual carotid compression is able to predict the degree of cross-over flow and tolerance of ICA occlusion. Methods: A prospective study was performed on 88 patients suffering from neck tumors or inoperable ICA aneurysms with planned ligation or permanent balloon occlusion of the ICA. Preceding a balloon occlusion lasting 20 min we performed TCD with manual carotid compression test. Insufficient cross-over flow during transient carotid occlusion was defined angiographically as missing opacification of the middle cerebral artery (MCA) after selective injection of contrast media in the contralateral ICA, and sonographically as a decrease greater than 60% in flow velocity of the MCA ipsilateral to the carotid occlusion. Results: TCD and angiography could be compared in 70 of 88 patients. Angiography showed no or insufficient collateral flow in 26%. All patients (n = 10) with a decrease in MCA velocity greater than 60% on angiography showed missing or poor cross-over flow. A greater than 50% increase in the anterior cerebral artery (ACA) predicted moderate or good cross-over flow in 98%. Clinical observation revealed 11 transient neurological deficits. Eight of them showed insufficient cross-over flow angiographically and sonographically. In 2 of 11 only TCD revealed such low collateral supply. Neither technique predicted hemodynamic ischemia in only 1 of the 11. Conclusion: TCD with carotid compression test is a valid method for predicting interhemispheric flow and clinically relevant hemodynamic compromise in cases of occlusion of the ICA.

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Section: Discussionmentioning

confidence: 99%

“…Monitoring of the MCA Doppler shift with TCD under balloon occlusion of the ICA combines the advantages of both methods [9, 10, 11, 12, 13]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Carotid Compression Test for Therapeutic Occlusion of the Internal Carotid Artery

Hetzel

Reutern²,

Wernz

et al. 2000

Cerebrovasc Dis

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Varying impact of common carotid artery digital compression and internal carotid artery balloon test occlusion on cerebral hemodynamics

Sorteberg

Bakke

et al. 1998

Head Neck

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Background The purpose of this study was to compare the cerebral hemodynamic changes brought about by common carotid artery (CCA) digital compression and angiographic internal carotid artery (ICA) balloon occlusion. Methods Bilateral transcranial Doppler ultrasonographic monitoring of the middle cerebral artery blood velocity (VMCA) was performed in 12 subjects with neck neoplasms or traumatic carotid‐cavernous fistulas. The MCA pulsatility index (PIMCA) and hemodynamic tension (Uhem MCA) were calculated. Results Common carotid artery compression provoked the largest drop in ipsilateral VMCA, PIMCA, and Uhem MCA. Common carotid artery compression caused a steal of blood from the intra‐ to the extracranial circulation, with the discrepancy in hemodynamic findings between CCA and ICA test occlusions being dependent on the quantity of reversed ipsilateral ICA blood flow. Conclusion If the carotid artery is to be sacrificed, permanent ICA closure is the procedure of choice with respect to the occurrence of cerebral ischemic lesions in patients with neck neoplasms and ICA flow reversal during CCA compression. © 1998 John Wiley & Sons, Inc. Head Neck 20: 687–694, 1998.

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Sonography of the Large Neck Vessels and of Tumors with Suspected Infiltration of the Large Neck Vessels

Welkoborsky

2019

Ultrasonography of the Head and Neck

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Multimodaler Karotisokklusionstest zur Bestimmung des Infarktrisikos vor therapeutischem Karotis-interna-Verschluß

Cited by 15 publications

References 0 publications

The Carotid Compression Test for Therapeutic Occlusion of the Internal Carotid Artery

The Carotid Compression Test for Therapeutic Occlusion of the Internal Carotid Artery

Varying impact of common carotid artery digital compression and internal carotid artery balloon test occlusion on cerebral hemodynamics

Sonography of the Large Neck Vessels and of Tumors with Suspected Infiltration of the Large Neck Vessels

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