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


CONCLUSIONS
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.
Sorteberg
A
A
Department of Neurosurgery, Rikshospitalet, The National Hospital, University of Oslo, Norway.
Sorteberg
W
W
Bakke
S J
SJ
Lindegaard
K F
KF
Boysen
M
M
Nornes
H
H
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D017536:Carotid Artery, Common / Q000503:physiopathology* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000503:physiopathology* / Q000601:surgery; D002404:Catheterization; D002426:Cavernous Sinus; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D005260:Female; D005402:Fistula / Q000503:physiopathology / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D017585:Ultrasonography, Doppler, Transcranial