Balloon test occlusion of the internal carotid artery with hypotensive challenge

摘要: PURPOSE To evaluate the usefulness of provocative testing with hypotensive challenge during balloon test occlusion internal carotid artery before sacrifice and to correlate tolerance clinical outcome after sacrifice. METHODS Forty-seven consecutive cases occlusions performed at our institution past 4 years were retrospectively reviewed. Occlusion was under normotensive conditions distal perfusion heparinized saline for 20 minutes, or until a deficit perceived. If minutes normotension tolerated, hypotension induced two thirds mean arterial pressure RESULTS Of 47 patients, (9%) had deficits normotension. remaining 43 9 (21%) hypotension. One patient positive underwent extracranial-intracranial bypass without sequelae. In one 19 patients who clinically tolerated (surgical ligation intracranial artery), mild embolic stroke developed, probably from giant wall aneurysm. This fully recovered; MR imaging showed changes consistent emboli Symptomatic complications noted in 2 (4%) asymptomatic dissections 3 (6%) patients. CONCLUSION Balloon is safe, economical, greatly increases sensitivity occlusion. The predictive value negative high. However, determine test9s specificity compared quantitative imaging, controlled trials will be necessary.