Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study

Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative,... This Article Free to Access Full Text Full Text (PDF) Supplemental Online Table All Versions of this Article: ajnr.A2522v1 32/7/1315 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Carlson, A. P. Articles by Yonas, H. PubMed PubMed Citation Articles by Carlson, A. P. Articles by Yonas, H. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1315-1320, August 2011 © 2011 American Society of Neuroradiology BRAIN Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study A.P. Carlson a , A.M. Brown a , E. Zager b , K. Uchino c , M.P. Marks d , C. Robertson e , G.P. Sinson f , A. Marmarou g and H. Yonas a a From the Department of Neurosurgery (A.P.C., A.M.B., H.Y.), University of New Mexico, Albuquerque, New Mexico. b Department of Neurosurgery (E.Z.) University of Pennsylvania, Philadelphia, Pennsylvania c Department of Neurology (K.U.), University of Pittsburgh, Pittsburgh, Pennsylvania d Department of Neuroradiology (M.P.M.), Stanford University, Palo Alto, California e Department of Neurosurgery (C.R.), Baylor College of Medicine, Houston, Texas f Department of Neurosurgery (G.P.S.), Medical College of Wisconsin, Milwaukee, Wisconsin g Division of Neurosurgery (A.M.), Medical College of Virginia, Richmond, Virginia. Please address correspondence to Howard Yonas, MD, Department of Neurosurgery, University of New Mexico, MSC10–5615, 1 University of New Mexico, Albuquerque, NM 87131-0001; e-mail: hyonas@salud.unm.edu BACKGROUND AND PURPOSE: Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US. MATERIALS AND METHODS: Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site. RESULTS: At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of >20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae. CONCLUSIONS: Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available. Abbreviations: CBF, cerebral blood flow • ED, emergency department • FDA, US Food and Drug Administration • ICP, intracranial pressure • IND, investigational new drug • pCO 2 , carbon dioxide partial pressure • PRS, prolonged respiratory suppression • TIA, transient ischemic attack • Xe-CT, xenon-enhanced CT Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study

Download PDF
6 pages

Loading next page...
 
/lp/american-journal-of-neuroradiology/xenon-enhanced-cerebral-blood-flow-at-28-xenon-provides-uniquely-safe-CqQ57YbXTw

References (48)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2522
Publisher site
See Article on Publisher Site

Abstract

This Article Free to Access Full Text Full Text (PDF) Supplemental Online Table All Versions of this Article: ajnr.A2522v1 32/7/1315 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Carlson, A. P. Articles by Yonas, H. PubMed PubMed Citation Articles by Carlson, A. P. Articles by Yonas, H. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1315-1320, August 2011 © 2011 American Society of Neuroradiology BRAIN Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study A.P. Carlson a , A.M. Brown a , E. Zager b , K. Uchino c , M.P. Marks d , C. Robertson e , G.P. Sinson f , A. Marmarou g and H. Yonas a a From the Department of Neurosurgery (A.P.C., A.M.B., H.Y.), University of New Mexico, Albuquerque, New Mexico. b Department of Neurosurgery (E.Z.) University of Pennsylvania, Philadelphia, Pennsylvania c Department of Neurology (K.U.), University of Pittsburgh, Pittsburgh, Pennsylvania d Department of Neuroradiology (M.P.M.), Stanford University, Palo Alto, California e Department of Neurosurgery (C.R.), Baylor College of Medicine, Houston, Texas f Department of Neurosurgery (G.P.S.), Medical College of Wisconsin, Milwaukee, Wisconsin g Division of Neurosurgery (A.M.), Medical College of Virginia, Richmond, Virginia. Please address correspondence to Howard Yonas, MD, Department of Neurosurgery, University of New Mexico, MSC10–5615, 1 University of New Mexico, Albuquerque, NM 87131-0001; e-mail: hyonas@salud.unm.edu BACKGROUND AND PURPOSE: Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US. MATERIALS AND METHODS: Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site. RESULTS: At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of >20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae. CONCLUSIONS: Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available. Abbreviations: CBF, cerebral blood flow • ED, emergency department • FDA, US Food and Drug Administration • ICP, intracranial pressure • IND, investigational new drug • pCO 2 , carbon dioxide partial pressure • PRS, prolonged respiratory suppression • TIA, transient ischemic attack • Xe-CT, xenon-enhanced CT Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Aug 1, 2011

There are no references for this article.