Preoperative Balloon Occlusion Test for Cranial Base Surgery with Single Photon Emission CT

In the treatment of complex paraclinoidal and giant cavernous aneurysms, preservation of the patency of the internal carotid artery (ICA) is not always possible, and therapeutic occlusion of the carotid is still an important option for their management. A complete preoperative evaluation of the carotid reserve circulation, including the use of temporary balloon occlusion test and single photon emission computerized tomography (SPECT) should be included in the current paradigms of paraclinoidal and intracavernous aneurysms management. We present a series of fifteen patients with sixteen giant or complex carotid cavernous or ophthalmic aneurysms that were treated following a protocol for our preoperative decision-making analysis. Extracranial to intracranial saphenous vein bypass was reserved to the cases where carotid occlusion would be associated with high risk of ischemic complications and was performed in three patients. Besides the difficulties in dealing with those complex aneurysms, good clinical outcome was possible in our experience with the designed paradigm.

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Brain Single-Photon Emission CT Physics Principles

American Journal of Neuroradiology ◽

10.3174/ajnr.a1175 ◽

2008 ◽

Vol 29 (7) ◽

pp. 1247-1256 ◽

Cited By ~ 14

Author(s):

R. Accorsi

Keyword(s):

Single Photon ◽

Photon Emission ◽

Single Photon Emission ◽

Single Photon Emission Ct

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New Cardiac Cameras: Single-Photon Emission CT and PET

Seminars in Nuclear Medicine ◽

10.1053/j.semnuclmed.2014.04.003 ◽

2014 ◽

Vol 44 (4) ◽

pp. 232-251 ◽

Cited By ~ 50

Author(s):

Piotr J. Slomka ◽

Daniel S. Berman ◽

Guido Germano

Keyword(s):

Single Photon ◽

Photon Emission ◽

Single Photon Emission ◽

Single Photon Emission Ct

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Diagnostic Accuracy of Single Photon Emission CT in Alzheimer-Type Dementia.

Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics ◽

10.3143/geriatrics.29.463 ◽

1992 ◽

Vol 29 (6) ◽

pp. 463-468 ◽

Cited By ~ 3

Author(s):

Haruo Hanyu ◽

Shinei Abe ◽

Hisayuki Arai ◽

Tetsuichi Asano ◽

Toshihiko Iwamoto ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Single Photon ◽

Photon Emission ◽

Alzheimer Type ◽

Single Photon Emission ◽

Alzheimer Type Dementia ◽

Single Photon Emission Ct

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Limited value of99mTc depreotide single photon emission CT compared with CT for the evaluation of pulmonary lesions

British Journal of Radiology ◽

10.1259/bjr/10438644 ◽

2012 ◽

Vol 85 (1015) ◽

pp. e307-e313 ◽

Cited By ~ 2

Author(s):

S W Harders ◽

H H Madsen ◽

K Hjorthaug ◽

M Rehling ◽

T R Rasmussen ◽

...

Keyword(s):

Single Photon ◽

Photon Emission ◽

Single Photon Emission ◽

Pulmonary Lesions ◽

Single Photon Emission Ct

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Prediction of Cerebral Hyperperfusion after Carotid Endarterectomy Using Cerebral Blood Volume Measured by Perfusion-Weighted MR Imaging Compared with Single-Photon Emission CT

Journal of Vascular Surgery ◽

10.1016/j.jvs.2007.11.038 ◽

2008 ◽

Vol 47 (1) ◽

pp. 240

Author(s):

T. Fukuda ◽

K. Ogasawara ◽

M. Kobayashi

Keyword(s):

Mr Imaging ◽

Carotid Endarterectomy ◽

Blood Volume ◽

Cerebral Blood Volume ◽

Single Photon ◽

Photon Emission ◽

Single Photon Emission ◽

Cerebral Hyperperfusion ◽

Single Photon Emission Ct

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Single-Photon Emission CT to Access Outcomes in Children with Moyamoya Syndrome and Sickle Cell Disease Before and After Encephaloduroarteriosynagiosis

Blood ◽

10.1182/blood.v118.21.2143.2143 ◽

2011 ◽

Vol 118 (21) ◽

pp. 2143-2143

Author(s):

Sharada A. Sarnaik ◽

Moira M. Lancelot

Keyword(s):

Cerebral Perfusion ◽

Pediatric Patients ◽

Single Photon ◽

Photon Emission ◽

Moyamoya Syndrome ◽

Cell Disease ◽

Single Photon Emission ◽

Vascular Reserve ◽

Single Photon Emission Ct ◽

Before And After

Abstract Abstract 2143 Background: About 11% of patients with sickle cell disease (SCD) will develop and ischemic stroke by 20 years. Patients with SCD and Moyamoya Syndrome (MMS) are at an especially high risk for developing stroke. Encephaloduroarteriosynagiosis (EDAS) is emerging as a safe and effective method for the treatment of MMS in Pediatric patients with SCD since it provides improved revascularization. Single-photon emission CT (SPECT) has been used in pediatric MMS patients to demonstrate regions of decreased cerebral perfusion and cerebrovascular reserve. The use of SPECT in SCD patients with MMS undergoing EDAS has not been evaluated. Methods: Between 2001 and 2011 we had 45 patients with SCD who developed clinical evidence of cerebrovascular accident (CVA), transient ischemic attack (TIA), or seizure with radiologic evidence (magnetic resonance and or angiography) of MMS. 20 underwent surgical revascularization with EDAS. Vascular reserve and cerebral perfusion was assessed with SPECT before and after EDAS in 9 patients. Results: 6/9 patients had bilateral EDAS while 3/9 had unilateral EDAS. The postoperative clinical outcome of each patient was assigned to one of the following 3 categories based on the SPECT reports: (1) improved if there was increased perfusion and vascular reserve after EDAS, (2) stable if there were no new areas of decreased perfusion or vascular reserve after EDAS and (3) worsened if there were new areas of decreased perfusion or vascular reserve with increased risk for future infarct after EDAS. 6/9 patients showed improvement, 2/9 patients showed stable cerebral perfusion and vascular reserve and 1 patient showed additional areas at risk for future infarct. SPECT was performed on average 5.7 (range 1.5–16.1) months before EDAS and 16.2 (range 1–47.1) months after EDAS. Conclusions: SPECT performed before and after EDAS of the involved cerebral hemispheres can assess effectiveness of revascularization surgery and may predict the further clinical outcomes of pediatric patients with SCD and MMS. Disclosures: No relevant conflicts of interest to declare.

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