Indicatie for an extracranial-intracranial bypass: either flow augmentation for patients with steno-occlusive vascular disease such as moyamoya disease or flow preservation when a major artery has to be sacrificed to treat an underlying disease such as a tumor of the central skull base or a complex intracranial aneurysm.
Conditions
Interventions
Patients will receive, randomly and sequentially, dobutamine (2-15 µg/kg/min) to increase the cardiac output and phenylephrine (0.15-1 µg/kg/min) to increase the blood pressure.
Sponsors
University Medical Center Utrecht
Eligibility
Inclusion criteria
Inclusion criteria: Adults, aged 18 years or above at day of surgery Indication for extracranial-intracranial bypass surgery
Exclusion criteria
Exclusion criteria: Patients within two weeks after a subarachnoid hemorrhage Language barrier Pregnancy Hypertrophic cardiomyopathy Left ventricular outflow tract obstruction Severe, untreated ventricular arrhytmia Severe hyperthyroidism Recent myocardial infarction ( 180 mmHg under general anesthesia before start of the study period
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| First, we will measure the graft flow rate to be used as a reference for graft perfusion. Afterwards the cardiac output or blood pressure is increased. Our main study parameter will be the mean (sd) change in graft flow for an increase in cardiac output compared to the reference phase and the mean (sd) change in graft flow for an increase in blood pressure, compared to the reference phase. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary endpoints are the absolute difference in increase (or decrease) in graft flow rate, cardiac output and blood pressure between dobutamine and phenylephrine treatment, as compared to the reference stage. | — |
Contacts
Public ContactA. Akkermans
UMC Utrecht, dep. of Anesthesiology
Outcome results
None listed