BRAIN BLOOD-FLOW SPECT IN TEMPORARY BALLOON OCCLUSION OF CAROTID AND INTRACEREBRAL ARTERIES

It is important to determine preoperatively which patients can tolerat e permanent occlusion of a cervical internal carotid or cerebral arter y when such a procedure may be necessary to treat cerebrovascular or n eoplastic lesions. Here we report our experience in combining temporar y intra-arterial balloon occlusion with concomitant cerebral blood flo w imaging in preoperative evaluation of such patients. Forty-two patie nts with a variety of cerebrovascular and neoplastic lesions underwent trial balloon occlusion of an internal carotid or intracerebral arter y. Eight patients developed both neurologic symptoms as well as brain perfusion defects during trial occlusion. Nine others developed only p erfusion defects. The remainder were asymptomatic and had negative sca ns. Brain blood flow imaging during intra-arterial balloon occlusion i dentified 17 patients potentially at risk for developing postsurgical ischemic deficits. Treatment alternatives to acute arterial sacrifice were developed for these patients.