CEREBRAL AUTOREGULATION IN PERINIDAL AREA OF BRAIN ARTERIOVENOUS MALFORMATION
https://doi.org/10.18705/2311-4495-2016-3-1-89-97
Abstract
Objective. To assess perioperative dynamics of cerebral autoregulation (CA) in patients with brain arteriovenous malformation (AVM) after endovascular interventions. Methods. The radicality of AVM embolization (Hystoacryl or Onyx) was evaluated in 47 patients by cerebral angiography and blood flow velocity index (FVI) in precerebral arteries with a Vivid E (USA) ultrasound scanner. We monitored blood flow velocity (BFV) in basal cerebral arteries with Multi Dop X (DWL, Germany) and blood pressure (BP) with CNAP (Austria). CA was assessed with cuff test (autoregulation index - ARI) and phase-shift (PS) between spontaneous oscillations of BP and BFV within the range of Mayer’s waves (0.08 - 0,12 Hz). Results. Pre-operative values of ARI and PS were 1,8 ± 0,7 and 0,3 ± 0,2 rad, respectively. Total FVI prior to embolization was 254 ± 336 ml/min, after embolization - 952 ± 305 ml/min (p<0,005). In 15 cases with total embolization significant (p<0,005) increase of rate of CA (ARI: 6,0 ± 1,1, PS: 0,9 ± 0,1 rad) was noted. In other two cases with total embolization, CA didn’t change significantly after operation. In 14 cases with subtotal embolization postoperative ARI and PS were 3,6 ± 0,5 and 0,7 ± 0,1 rad, respectively (p<0,05), and in cases with partial elimination were 2,1 ± 0,6 and 0,4 ± 0,1 rad (p>0,05). Conclusion. CA assessment could be used for detection of its real impairment in perinidal area of AVM during the staged endovascular treatment and for prognostication of postoperative complications.
About the Authors
V. B. Semenyutin
Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
G. K. Panuntsev
Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
V. A. Aliev
Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
A. . Patzak
Johannes-Muller Institute of Physiology University Hospital Charite, Humboldt University
Russian Federation
Russian Federation
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Review
For citations:
Semenyutin V.B., Panuntsev G.K., Aliev V.A., Patzak A. CEREBRAL AUTOREGULATION IN PERINIDAL AREA OF BRAIN ARTERIOVENOUS MALFORMATION. Translational Medicine. 2016;3(1):89-97. (In Russ.) https://doi.org/10.18705/2311-4495-2016-3-1-89-97
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