Hemodynamic changes in ipsi- and contralateral cerebral arterial territories after carotid endarterectomy using positron emission tomography

• Published in: Surgical neurology Vol. 71; no. 6; pp. 668 - 676
• Main Authors: Rijbroek, Abraham, MD, Boellaard, Ronald, PhD, Vermeulen, Erik G.J., MD, Lammertsma, Adriaan A., MD, Rauwerda, Jan A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2009
• Subjects: Blood Flow Velocity - physiology; Blood Volume - physiology; Carotid endarterectomy; Carotid Stenosis - diagnosis; Carotid Stenosis - physiopathology; Carotid Stenosis - surgery; Cerebral arterial territory; Cerebral blood flow; Cerebral blood volume; Cerebrovascular Circulation - physiology; Cohort Studies; Endarterectomy, Carotid; Female; Humans; Imaging, Three-Dimensional; Male; Mean vascular transit time; Neurology; Positron emission tomography; Retrospective Studies; Surgery; magnetic resonance; magnetic resonance imaging; MRI; CBF; extracranial-intracranial bypass surgery; MVTT; SPECT; cerebral vascular reactivity; CBV; volumes of interest; carotid endarterectomy; CEA; ACA; mean vascular transit time; CO 2; carbon dioxide; EICB; MR; EEG; posterior cerebral artery; elektroencefalogram; MCA; transcranial doppler; CVA; PCA; medial cerebral artery; transcranial color-coded duplex; OEF; VOI; cerebrovascular event; TCD; single photon emission computerized tomography; Cerebral arterial territory; cerebral blood volume; TCCD; cerebral blood flow; positron emission tomography; MRA; magnetic resonance angiography; oxygen extraction fraction; anterior cerebral artery; CVR; PET; Carotid endarterectomy; Cerebral blood flow; Mean vascular transit time; Cerebral blood volume; Positron emission tomography
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2008.04.027

Abstract Background The purpose of this study was to characterize ipsi- and contralateral cerebral hemodynamics before and after CEA. Methods Cerebral blood flow, CBV, and MVTT were measured in 10 patients before and after CEA using PET. Absolute and relative values of these parameters were calculated bilaterally for the entire arterial territories and hemispheres. Results For all territories in both hemispheres, the mean absolute postoperative CBF was significantly increased compared with preoperative CBF ( P < .05). Only in MCA was this increase higher in the ipsilateral than in the contralateral hemisphere ( P = .02). Cerebral blood volume was unaffected, whereas MVTT decreased in ipsilateral MCA ( P = .05). Conclusions The present findings suggest that, on the first day after CEA, absolute CBF is increased in all arterial territories on both ipsi- and contralateral sides, but that there are only minor changes in the relative distribution, whereas the CBV was unaffected.