Abstract
Changes in cerebral blood flow in response to acetazolamide (ACZ) were evaluated using transcranial Doppler (TCD) as a parameter of cerebrovascular reserve capacity (CVR) in 9 patients who underwent carotid endarterectomy (5 cases, CEA group) and EC-IC bypass (4 cases of STA-MCA anastomosis, bypass group) . TCD data were obtained before and after intravenous administration of ACZ. The percentage change in mean flow velocity (%ΔMFV) was measured as CVR. TCD was performed before, 2 weeks after, and 4-6 months after surgery.
In the CEA group with high-grade stenosis, MFV did not change significantly before and after surgery, but % ΔMFV was significantly improved 2 weeks after surgery. In the bypass group, MFV and %ΔMFV did not change significantly before and 2 weeks after surgery, but %ΔMFV was significantly improved 4-6 months after surgery.
In conclusion, during the perioperative period after reconstruction surgery for occlusive cerebrovascular disease, measurement of %ΔMFV with TCD may be of great value for estimating the change in cerebrovascular reserve capacity, similarly to PET, SPECT, and Xe-CT.
