Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Dec;27(6):544-7.
doi: 10.1007/s00276-005-0032-5. Epub 2005 Sep 1.

The value of phase-contrast magnetic resonance angiography of the circle of Willis in predicting cerebral ischemia-hypoxia (shunt need) during carotid endarterectomy

Affiliations

The value of phase-contrast magnetic resonance angiography of the circle of Willis in predicting cerebral ischemia-hypoxia (shunt need) during carotid endarterectomy

P Bagan et al. Surg Radiol Anat. 2005 Dec.

Abstract

Background: Cerebral perfusion during carotid cross-clamping depends on collateral function of the circle of Willis. The aim of this study was to determine the value of 3D Phase-Contrast (3D PC) MR angiography in predicting pre-operatively the need of shunting.

Methods: 3D PC MR angiography were performed in 121 patients before carotid endarterectomy under locoregional anaesthesia. Based on the MR analysis, the risk of cerebral ischemia-hypoxia during clamping was classified as high, moderate and low. The analysis was then correlated with intraoperative neurological examination.

Results: In patients with high risk of cerebral ischemia (n=9), immediate cerebral ischemia developed in all patients within one min of clamping (P<0.001). All nine underwent shunt placement. In six of the patients with moderate risk (n=46), cerebral ischemia occurred between 20 and 25 min after clamping; All occurred during intraoperative hypotension.

Conclusion: 3D PC MR angiography can significantly determine the need of shunting in patients with important risk of immediate intraoperative cerebral ischemia. It also focuses on the intraoperative blood pressure stability in patients with moderate risk of ischemia.

PubMed Disclaimer

References

    1. Acta Radiol. 2000 May;41(3):204-10 - PubMed
    1. Stroke. 1998 Oct;29(10 ):2038-42 - PubMed
    1. Neurol Res. 2002 Apr;24(3):237-40 - PubMed
    1. AJNR Am J Neuroradiol. 2004 Apr;25(4):558-64 - PubMed
    1. J Am Coll Surg. 1999 Jul;189(1):93-100; discussion 100-1 - PubMed

MeSH terms

LinkOut - more resources