Temporary balloon occlusion of the carotid artery combined with brain blood flow imaging as a test to predict tolerance prior to permanent carotid sacrifice.
OBJECTIVE
To describe the technique of using SPECT brain blood flow imaging to identify patients at risk for having strokes after balloon or surgical ligation of an internal carotid artery.


METHODS
29 patients underwent temporary balloon occlusion of the internal carotid artery and blood flow imaging studies were obtained prior to sacrifice of the vessel; 11 internal carotid arteries were indeed sacrificed and form the basis of our study. Follow-up of these patients ranged from 3 to 65 days.


RESULTS
Three groups emerged: group I, patients with symptoms during occlusion and an abnormal blood flow study (one patient); group II, patients with no symptoms during the occlusion but with an unequivocally abnormal blood flow study (two patients); group III, patients without symptoms during occlusion and a normal or slightly abnormal blood flow study (eight patients).


CONCLUSIONS
Carotid sacrifice without initial and temporary balloon occlusion is unnecessarily risky. Imaging of blood flow in the brains of these patients can further improve the safety of occlusion procedures in the internal carotid artery.
Eckard
D A
DA
University of Texas Southwestern Medical Center, Dallas 75235-8896.
Purdy
P D
PD
Bonte
F J
FJ
D000293:Adolescent; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000502:physiology*; D002560:Cerebrovascular Circulation; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon