SIR 2024
Neurointerventional Radiology
Koustav Pal, MBBS
Postdoctoral Research Fellow
MD Anderson
Financial relationships: Full list of relationships is listed on the CME information page.
Ahmed Awad, MBBS
Fellow
The University of Texas Health Science Center at Houston/MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Stephen Chen, MD
Associate Professor
MD Anderson
Financial relationships: Full list of relationships is listed on the CME information page.
To correlate whether visualization of vessels and their sizes, alongside changes in vitals(SBP, DBP, and MAP), can predict balloon test passing or failing as well as prediction of ischemic events.
Materials and methods: A single-institution retrospective analysis of patients with balloon testing for the past four years was performed. Complications were categorized based on the Common Terminology Criteria for Adverse Events (CTCAE) classification system.
Results:
Balloon test occlusion of the carotid artery is a routinely performed test to prevent ischemic events following carotid sacrifice. There are various methods of confirming whether the testing causes neurological deficits, such as clinical neurologic testing or visual confirmation. Previous studies have correlated either visualization or vitals with the prediction of post-sacrifice ischemic events.
There were 37 balloon test procedures in 30 patients. Among 37 procedures, 28(75%) passed the balloon test. 20 Balloon tests were performed in the CCA and 17 were performed in the ICA. There were 0 strokes in those who passed the balloon test with low cortical venous delay (< 2 seconds). Univariate logistic regression demonstrated that ACOMsize(OR=6.10, p=0.0179), and PCOM visualization (OR= 3.22, p=0.0016) were significant for predicting balloon test passing. ACOM visualization, PCOM size, and changes in MAP were not substantial in predicting balloon test passing.
Conclusion: PCOM visualization and ACOM size can be useful predictors of passing balloon testing and preventing ischemic events.