Key result
Carotid stenosis linked to ~39% lower cerebrovascular reserve on acetazolamide TCD testing.
Why the study?
The time course of the acetazolamide effect on cerebrovascular reserve in patients with extracranial carotid artery disease was not fully characterized by standard two-point TCD measurements.
Does continuous TCD monitoring of the acetazolamide effect improve the detection of impaired cerebrovascular reserve compared to standard two-point measurement in patients with carotid artery disease?
Population
51 patients with extracranial carotid artery disease and 18 normal subjects
Comparison
Continuous bilateral TCD monitoring over 45 minutes after acetazolamide injection vs standard two-point TCD measurement
Design
Observational study with bilateral TCD monitoring
Follow-up
45 minutes
Authors
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Continuous TCD monitoring may detect more impaired cerebrovascular reserve than standard two-point testing; leaves open whether it refines risk stratification in carotid disease.
Observational (n=69)
Does continuous TCD monitoring of the acetazolamide effect improve the detection of impaired cerebrovascular reserve compared to standard two-point measurement in patients with carotid artery disease?
Absolute Event Rate: 587.2% vs 967.8%
p-value: p=<0.01
Continuous TCD monitoring of the acetazolamide effect provides additional information on cerebrovascular reserve and improves the detection of impairment in patients with carotid artery disease compared to standard two-point measurement.
Stoll et al. (1996) conducted an observational in Extracranial carotid artery disease (n=69). Acetazolamide test vs. Normal subjects was evaluated on Integral of the mean flow velocity (p=<0.01). Acetazolamide testing showed a reduced integral of mean flow velocity in patients with unilateral (587.2 cm) and bilateral (728.9 cm) carotid stenosis versus normal subjects (967.8 cm, p<0.01).
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