Naslov
DSA and CTA as confirmatory tests for diagnosis of brain death.

Autori
Schmidt Saša

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
2012 ETCO-EDC Abstract Book / - Dubrovnik, 2012, 24-24

Skup
2012 European Organ Donation Congress, European Society for Organ Transplantation 05-07. 10. 2012. Dubrovnik, Croatia

Mjesto i datum
Dubrovnik, Hrvatska, 05.10.2012. - 07.10.2012

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
DSA; CTA; brain death

Sažetak
MO04 - DSA AND CTA AS CONFIRMATORY TESTS FOR DIAGNOSIS OF BRAIN DEATH Saša Schmidt MD Phd1 ; 1 Clinical Medical Centre Sestre milosrdnice, Zagreb, Croatia Introduction: Brain death (BD) is defined as irreversible cessation of brain functions including the brain stem. The diagnosis is mainly clinical and includes irreversible coma, absence of motor responses to pain, absence of brain stem reflexes and apnea. In many countries confirmatory tests are required for the diagnosis of BD only in cases where a clinical examination is not appropriate because the loss of cerebral function is unclear, while in some countries the confirmatory tests are mandatory in patients who meet the clinical criteria of death. Methods: In Croatia the BD cannot be determined by a single clinical observation and one of the seven ancillary tests is mandatory. To demonstrate cessation of the cerebral circulation with DSA, both common carotid arteries and the dominant vertebral artery have to be catheterized. Cessation of the cerebral circulation is considered if the arteries and veins are not discernible in either the supratentorial or in the infratentorial compartment. The standard CTA protocol consisted of an unenhanced CT study of the head, a CTA of the cervical and intracranial vessels and a late venous-phase of the skull. Therefore, there is no consensus about interpretation of CTA for brain circulatory arrest in Croatia, lack of opacification of arteries above the carotid syphon and foramen magnum was classified as positive. Results: Out of 35explantations in our institution in 2011., 17 were declared BD according to clinical exam and transcranial duplex sonography.16 out of 23 patients have positive CT angiography and 2 out of 3 patients who undergo DSA have brain circulatory arrest. Conclusion: Despite DSA being considered the „gold standard“ there are many concerns with its use. CTA is a highly sensitive method but needs clear interpretation protocol.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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