Venous Phase Timing Does Not Predict SPECT Results during Balloon Test Occlusion of the Internal Carotid Artery.

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Venous Phase Timing Does Not Predict SPECT Results during Balloon Test Occlusion of the Internal Carotid Artery.

World Neurosurg. 2017 Mar 15;:

Authors: Snelling BM, Sur S, Shah SS, Wolfson RI, Ambekar S, Yavagal DR, Elhammady MS, Peterson EC

Abstract
INTRODUCTION: The purpose of this study is to evaluate the role of venous phase timing when compared to Technetium-99m Single Photon Emission Computed Tomography (SPECT) during angiographic balloon test occlusion of the internal carotid artery (ICA) and subsequent sacrifice of the ICA.
METHODS: Fifty-six patients underwent formal BTO from April 2008, to February 2014, at our institution. Venous phase timing was calculated for each patient. SPECT imaging for each patient was interpreted by the nuclear medicine radiologist. Statistical analysis between the three groups (No Hypoperfusion, Mild Hypoperfusion, Moderate/Severe Hypoperfusion) was calculated using ANOVA.
RESULTS: Twenty-six patients showed no hypoperfusion during SPECT. The average delay of venous phase for these patients was 0.65 seconds. Eight of the 26 patients went on to have vessel sacrifice, with none showing evidence of infarction at the time of discharge. Six patients showed evidence of mild hypoperfusion on SPECT. None of these patients went on to have vessel sacrifice. The average venous delay was 0.5 seconds. Twenty-four patients were found to have moderate or severe hypoperfusion. The average venous delay was 1.08 seconds. ANOVA between the three groups demonstrated no significant difference (p=0.22).
CONCLUSION: Our study demonstrated no correlation between venous phase timing and SPECT. Future studies comparing multiple tests with patients who have had vessel occlusion are necessary to determine the best adjunctive measures to predict delayed ischemia following carotid occlusion.

PMID: 28315799 [PubMed - as supplied by publisher]

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