[Evaluation of Matas test by CBF studies, angiographic cross-filling and stump pressure in CEA patients].

Temporary and/or permanent occlusion of carotid artery is one of the most important strategy in the surgical treatment for cervical vascular and paraclinoid lesions. Cerebral ischemia produced by this procedure should be preoperatively grasped for the safety of the surgeries. Matas test has been widely applied to estimate the collateral blood flow at the main artery occlusion by observing only clinical features. In this study, we measured CBF and common carotid artery stump pressure (CCA stump P) in contrast to angiographic cross-filling in 43 carotid endarterectomy (CEA) patients to quantitatively evaluate Matas test. The patients were manually occluded the CCA on the affected side and clinically observed for at least 10 minutes. CCA stump P and cross-filling were evaluated in all patients and CBF measurements were carried out in the patients who clinically tolerated Matas test. CBF studies were performed by single photon emission CT with Xe-133 inhalation method and CBF values were obtained in the middle cerebral artery territory before and during Matas test. CCA stump P was measured during carotid angiography by manual occlusion of the proximal site of the CCA. Cross-filling was evaluated with the contralateral carotid angiography during the manual occlusion of the affected CCA. CBF changes in Matas test were classified into the following four patterns; bilateral mild decreases in CBF, unilateral severe decrease in CBF, unilateral mild decrease in CBF and no decrease in CBF. The frequency of bilateral mild decreases in CBF, unilateral severe decrease in CBF, unilateral mild decrease in CBF and no decrease in CBF were 8, 10, 14, 7 of 43 patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)