VARYING IMPACT OF COMMON CAROTID-ARTERY DIGITAL COMPRESSION AND INTERNAL CAROTID-ARTERY BALLOON TEST OCCLUSION ON CEREBRAL HEMODYNAMICS

Background. The purpose of this study waste compare the cerebral hemod ynamic changes brought about by common carotid artery (CCA) digital co mpression and angiographic internal carotid artery (ICA) balloon occlu sion. Methods. Bilateral transcranial Doppler ultrasonographic monitor ing of the middle cerebral artery blood velocity (V-MCA) was performed in 12 subjects with neck neoplasms or traumatic carotid-cavernous fis tulas. The MCA pulsatility index (Pl(MCA)) and hemodynamic tension (U- hem MCA) were calculated. Results. Common carotid artery compression p rovoked the largest drop in ipsilateral V-MCA, Pl(MCA), and U-hem MCA. Common carotid artery compression caused a steal of blood from the in tra-to the extracranial circulation, with the discrepancy in hemodynam ic findings between CCA and ICA test occlusions being dependent on the quantity of reversed ipsilateral ICA blood flow. Conclusion. If the c arotid artery is to be sacrificed, permanent ICA closure is the proced ure of choice with respect to the occurrence of cerebral ischemic lesi ons in patients with neck neoplasms and ICA flow reversal during CCA c ompression. (C) 1998 John Wiley & Sons, Inc.