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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acetazolamide, Aged, Aged, 80 and over, Blood Flow Velocity, Brain Ischemia, Carotid Stenosis, Cerebrovascular Circulation, Endarterectomy, Carotid, Female, Humans, Ischemic Attack, Transient, Male, Middle Aged, Middle Cerebral Artery, Monitoring, Intraoperative, Predictive Value of Tests, Preoperative Care, Prospective Studies, ROC Curve, Risk Assessment, Sampling Studies, Sensitivity and Specificity, Survival Analysis, Ultrasonography, Doppler, Transcranial.
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Does cerebral vasoreactivity predict cerebral ischaemia during carotid endarterectomy? Context: Assessment of cerebrovasoreactivity (CVR), obtained by transcranial Doppler (TCD) and the acetazolamide test to predict cases requiring selective carotid shunting on the basis of neurologic monitoring. A consecutive series of 87 carotid endarterectomy (CEA) cases was studied. Before surgery CVR was evaluated by measuring the mean velocity of the middle cerebral artery (mvMCA) using TCD at the basal condition and at 30 min after intravenous administration of acetazolamide (1 g). Carotid shunting was performed using neurologic monitoring under local anesthesia. Receiver operating characteristic (ROC) curve was calculated for sensitivity and specificity for various CVR cut offs. The ROC curve demonstrated that there was no single CVR cut off with both sensitivity and specificity above 80%.
assistant
The present study, which employed neurologic monitoring as the method of comparison, did not prove that CVR, as calculated by TCD and the acetazolamide test, is a valid preoperative test for predicting cerebral ischaemia caused by carotid clamping. Final Decision: no