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Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT

Abstract

Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic  More>>
Authors:
Kim, J S; Kim, G E; Yoo, J Y; Kim, D G; Moon, D H [1] 
  1. Asan Medical Center, Seoul (Korea, Republic of)
Publication Date:
Jul 01, 2005
Product Type:
Conference
Resource Relation:
Conference: 44. Annual Autumn Meeting of the Korean Society Nuclear Medicine, Seoul (Korea, Republic of), 18-19 Nov 2005; Related Information: In: Proceedings of the Korean Society Nuclear Medicine Autumn Meeting 2005, [498] pages.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CAROTID ARTERIES; PATIENTS; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
OSTI ID:
21230274
Research Organizations:
KSNM, Seoul (Korea, Republic of)
Country of Origin:
Korea, Republic of
Language:
English
Other Identifying Numbers:
TRN: KR0902863095973
Availability:
Available from KSNM, Seoul (KR)
Submitting Site:
KRN
Size:
2 pages
Announcement Date:
Dec 03, 2009

Citation Formats

Kim, J S, Kim, G E, Yoo, J Y, Kim, D G, and Moon, D H. Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT. Korea, Republic of: N. p., 2005. Web.
Kim, J S, Kim, G E, Yoo, J Y, Kim, D G, & Moon, D H. Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT. Korea, Republic of.
Kim, J S, Kim, G E, Yoo, J Y, Kim, D G, and Moon, D H. 2005. "Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT." Korea, Republic of.
@misc{etde_21230274,
title = {Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT}
author = {Kim, J S, Kim, G E, Yoo, J Y, Kim, D G, and Moon, D H}
abstractNote = {Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic improvement compared to no change group (p<0.05). Marked gait improvement and cerebrovascular hemodynamic improvement were noted in 53% and 61% of the patient who had less than 3 month history of symptom compared to 31% and 24% of the patients who had longer than 3 months, respectively (p<0.05). Marked gait improvement was obtained in patients who had improvement of cerebrovascular hemodynamic status on Acz-SPECT after CEA. These results suggest functional improvement such as gait can result from the improved perfusion of misery perfusion area, which is viable for a longer period compared to literatures previously reported.}
place = {Korea, Republic of}
year = {2005}
month = {Jul}
}