Prediction of the Cerebral Hyperperfusion Phenomenon after Carotid Endarterectomy Using a Transit Time Flowmeter
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- MATSUMURA Hideaki
- Department of Neurosurgery, University of Tsukuba
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- ITO Yoshiro
- Department of Neurosurgery, University of Tsukuba
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- UEMURA Kazuya
- Department of Neurosurgery, Tsukuba Medical Center Hospital
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- NAKAI Yasunobu
- Department of Neurosurgery, Tsukuba Medical Center Hospital
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- KOMATSU Yoji
- Department of Neurosurgery, Hitachi Medical Education and Research Center, University of Tsukuba Hospital
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- ISHIKAWA Eiichi
- Department of Neurosurgery, University of Tsukuba
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- MATSUMARU Yuji
- Department of Neurosurgery, University of Tsukuba
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- MATSUMURA Akira
- Department of Neurosurgery, University of Tsukuba
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Abstract
<p>The purpose of this study was to investigate the relationship between the cerebral hyperperfusion phenomenon (CHP) and carotid artery flow volume as measured by a transit time flowmeter during carotid endarterectomy (CEA). We retrospectively investigated 74 patients who underwent both transit time flowmetry and single photon emission computed tomography (SPECT). The flow volumes of the internal carotid artery (ICA) before and after the endarterectomy were recorded during surgery as the pre- and the post-ICA (mL/min), respectively. We defined the difference between the pre- and the post-ICA as the ΔIC (mL/min). Two independent board-certified neurosurgeons analyzed the asymmetry index (affected side/contralateral side) of regional qualitative cerebral blood flow before and after the CEA respectively. We defined the CHP as an excessive increase in this asymmetry index between preoperative and postoperative SPECT. The CHP was observed in five of the 74 patients (6.8%). The pre-ICA of the CHP cases was significantly lower than that of the non-CHP cases (in mL/min, median 29 vs. 97; P = 0.01). The ΔIC of the CHP cases was significantly higher than that of the non-CHP cases (in mL/min, median 154 vs. 50; P = 0.002). The cut-off value of the ΔIC was 81 mL/min (sensitivity 100%, specificity 78.3%, area under the curve 0.912). The findings of this study suggest that the ΔIC is associated with the CHP. The transit time flowmeter is useful to predict the CHP during surgery.</p>
Journal
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 60 (2), 94-100, 2020
The Japan Neurosurgical Society
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Details 詳細情報について
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- CRID
- 1390002184875624192
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- NII Article ID
- 130007798582
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- NII Book ID
- AN00358613
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- ISSN
- 13498029
- 04708105
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- HANDLE
- 2241/00161282
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- PubMed
- 31866664
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- Text Lang
- en
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- Data Source
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- JaLC
- IRDB
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed