Characterization of the cerebral blood flow response to balloon deflation after temporary internal carotid artery test occlusion.
Characterization of the cerebral blood flow response to balloon deflation after temporary internal carotid artery test occlusion.
复制标题
颈内动脉临时闭塞后脑血流对球囊放气反应的表征。
DOI：
10.1097/00008506-200204000-00006
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Ostapkovich,Noeleen
中科院分区：
文献类型：
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作者：
Gupta,DhaneshK;Young,WilliamL;Hashimoto,Tomoki;Halim,AlexanderX;Marshall,RandolphS;Lazar,RonaldM;Joshi,Shailendra;Pile-Spellman,John;Ostapkovich,Noeleen
作者检验了急性和相对短暂的颈内动脉（ICA）试验闭塞后脑血流量（CBF）增加的假设，并检查了放气后CBF与神经系统症状发展的关系。在16例接受ICA试验闭塞和控制性低血压的患者中，作者测量了基线、闭塞和放气时的颈动脉内133 mmHg CBF。4例患者在闭塞期间出现神经系统症状。作为阳性对照，另外11名患者在放气前接受颈动脉内维拉帕米或罂粟碱作为另一方案的一部分。球囊闭塞持续时间为23.1 ± 10.5分钟（平均值±标准差）。球囊回缩后1.3 ± 1.6分钟，CBF有增加趋势（12 ± 31%）（48 ± 9 mL/100 g/min vs 53 ± 17 mL/100 g/min，P =.脑血管阻力降低16 ± 27%（CVR; 2.1 ± 0.6 mm Hg/100 g/min/mL vs 1.7 ± 0.6 mm Hg/100 g/min/mL，P =. 03)与基线值相比。相比之下，接受颈动脉内扩张器的患者表现出CBF增加53 ± 55%（48 ± 10 mL/100 g/min vs 70 ± 23 mL/100 g/min，P =. 007)CVR降低33 ± 31%（2.2 ± 0.6 mm Hg/100 g/min/mL vs. 1.4 ± 0.6 mm Hg/100 g/min/mL，P =. 0007）与基线相比。方差分析和回归分析显示，闭塞后CBF和球囊闭塞时间，远端颈内动脉闭塞（"残端"）压力，或神经症状的发展之间没有其他关系。ICA血流的急性暂时中断导致脑血管血流动力学的最小闭塞后变化，即使是在试验闭塞期间出现神经系统症状的患者。
The authors tested the hypothesis that cerebral blood flow (CBF) would increase after acute and relatively brief internal carotid artery (ICA) test occlusion, and examined the relationship of the postdeflation CBF to the development of neurologic symptoms. In 16 patients undergoing ICA test occlusion with deliberate hypotension, the authors measured intracarotid 133 Xe CBF at baseline, occlusion, and deflation. Four patients developed neurologic symptoms during occlusion. As positive controls, 11 other patients received intracarotid verapamil or papaverine before deflation as part of another protocol. Balloon occlusion was 23.1±10.5 minutes (mean±standard deviation) in duration. At 1.3±1.6 minutes after balloon deflation, there was a trend (12±31%) for CBF to increase (48±9 mL/100 g/min versus 53±17 mL/100 g/min, P=. 15), and a 16±27% decrease in cerebrovascular resistance (CVR; 2.1±0.6 mm Hg/100 g/min/mL versus 1.7±0.6 mm Hg/100 g/min/mL, P=. 03) compared with baseline values. By comparison, patients who received a intracarotid dilator demonstrated a 53±55% increase in CBF (48±10 mL/100/min versus 70±23 mL/100 g/min, P=. 007) and a 33±31% decrease in CVR (2.2±0.6 mm Hg/100 g/min/mL versus 1.4±0.6 mm Hg/100 g/min/mL, P=. 0007) compared with baseline. Analysis of variance and regression analysis showed no other relationships between postocclusion CBF and balloon occlusion duration, distal internal carotid occlusion (“stump”) pressure, or the development of neurologic symptoms. Acute, temporary interruption of ICA blood flow resulted in minimal postocclusive changes in cerebrovascular hemodynamics, even in those patients who developed neurologic symptoms during the period of test occlusion.