Journal «Angiology and Vascular Surgery» • 

1997 • VOLUME 3 • №2

DYNAMIC X-RAY COMPUTED TOMOGRAPHY IN EVALUATION OF THE EFFICACY OF EXTRAINTRACRANIAL MICROANASTOMOSIS IN INTERNAL CAROTID ARTERY OCCLUSION

Ye.B. Cooperberg, A.V. Lavrentyev, V.N. Makarenko, N.V. Gubskaya, A.E. Gaidashev, M.G. Tutova
Division of Surgical Treatment of Cerebral Circulatory Disorders,
Department of Vascular Surgery, A.N. Bakulev Scientific Centre of Cardiovascular Surgery, Russian Academy of Medical Sciences, Department of Roentgenosurgery, Central Military Clinical Hospital of Infernal Forces, Ministry of Home Affairs of the Russian Federation,
Moscow, Russia

Transcranial Doppler and dynamic X-ray computed tomography were employed to exemine / 8 patients with atherosclerotic occlusion of the internal carotid artery. Of these, 10 patients were examined before and after extraintracranial microanastomosis establishment. The studies have shown that the activation hypercapnic test permitted quantitative estimation of the central perfusion reserve in patients with internal carotid artery occlusion. The use of dynamic X-ray computed tomography makes it possible to estimate the collateral pathways and their functional capability. The use of both transcranial Doppler and dynamic X-ray computed tomography allows prediction and estimation of the results of extraintracranial microanastomosis performance together with its clinical and hemodynamic efficiency. Dynamic X-ray computed tomography has also demonstrated that cortical anastomoses play a very important role in collateral compensation in functional insufficiency of the arterial circle of Willis. The hemodynamic sufficiency of an extraintracranial microanastomosis provides for perfusion increase in the middle cerebral artery and for adequate perfusion in the adjacent vascular pools on the side of internal carotid artery occlusion. The low perfusion reserve and local cortical reactive hyperemia in the vascular pools around the middle cerebral artery (in accordance with the dynamic X-ray computed tomography data) are indicationsor operation of an extraintracranial microanastomosis performance.

P. 19

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