Color Doppler ultrasonography for predicting the patency of anastomosis after superficial temporal to middle cerebral artery bypass surgery

Author(s):  
Jang Hun Kim ◽  
Sung-Kon Ha ◽  
Sung-Won Jin ◽  
Hae-Bin Lee ◽  
Sang-Dae Kim ◽  
...  
1979 ◽  
Vol 51 (4) ◽  
pp. 455-465 ◽  
Author(s):  
Richard E. Latchaw ◽  
James I. Ausman ◽  
Myoung C. Lee

✓ Pre- and postoperative angiograms on 40 patients undergoing superficial temporal-middle cerebral artery (STA-MCA) bypass surgery have been examined in detail. Multiple postoperative angiograms have been obtained to evaluate the change in both the bypass circuit and the intracranial circulation over time. A reproducible system for evaluating the degree of intracranial vascular filling via the bypass is introduced. The study shows that the STA and its anastomotic branch increase in size over time, measured in months, in the majority of patients. This is paralleled by a progressive increase in the degree of intracranial vascular filling. These changes are proportional to the severity of the vascular disease before surgery. The pattern of preoperative collateral circulation may change over time following the addition of the bypass circuit. The progressive change over time suggests that a static analysis at one time may belie the true effect of the surgery. The change of collateral circulation, with augmentation of blood supply to areas of the brain other than those affected by the recent ischemic event, means that a total cerebral evaluation including neuropsychological testing may be necessary for adequate evaluation of the effect of the bypass surgery.


2019 ◽  
Vol 47 (4) ◽  
pp. 290-295
Author(s):  
Ryo SUZUKI ◽  
Isao KITAHARA ◽  
Ataru FUKUDA ◽  
Hiroshi YONETANI ◽  
Tomoki YOKOCHI ◽  
...  

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Junxue Gao ◽  
Zhou Zhao ◽  
Jiaan Zhu ◽  
Hui Tian ◽  
Yuejie Liu

<b><i>Introduction:</i></b> The value of color Doppler ultrasonography (CDUS) with the supraclavicular approach for preoperative evaluation of the native left internal mammary artery (LIMA) as well as for the postoperative detection of LIMA graft patency was recently suggested. However, the parameters such as the flow volume and pulsatile index (PI) have not been studied in detail. <b><i>Objectives:</i></b> The objectives of this study were to analyze the LIMA data in the perioperative period and explore the relationships between the intraoperative graft flow with transit-time flow measurement (TTFM) and the postoperatively measured parameters with CDUS. <b><i>Methods:</i></b> Fifty-eight patients with significant stenosis (≥70%) or occlusions in left anterior descending artery (LAD) who were referred for isolated coronary artery bypass grafting (CABG) were enrolled in this study and examined by CDUS prior to CABG from April to July 2016. The perioperative measurements of proximal LIMA by CDUS were compared. In addition, the correlation between the intraoperative graft flow, such as the mean graft flow (MGF) and PI, and the immediate postoperative measurements of CDUS in LIMA bypassed grafts was statistically analyzed. <b><i>Results:</i></b> Six patients were excluded due to screening failure, or insufficient visualization of CDUS images for analysis. Fifty-two patients with in situ LIMA-LAD graft, with or without additional arterial grafts or saphenous vein grafts, were included in the final analysis. The postoperative diameters of proximal LIMA were not significantly different from preoperative diameters (2.21 ± 0.18 vs. 2.27 ± 0.22 mm, <i>p</i> = 0.070). The flow volume on the early postoperative CDUS significantly increased (39.77 ± 21.59 vs. 25.96 ± 13.17 mL/min, <i>p</i> &#x3c; 0.001) and the PI significantly decreased (1.43 ± 0.46 vs. 4.20 ± 1.49, <i>p</i> &#x3c; 0.001) versus those of preoperative measurements. The MGF had a moderate correlation with the flow volume on the early postoperative CDUS (<i>r</i> = 0.414, <i>p</i> = 0.002), and the PI by TTFM had a weak correlation with that by CDUS (<i>r</i> = 0.353, <i>p</i> = 0.010) as well. <b><i>Conclusions:</i></b> The MGF and PI by TTFM in CABG were associated with in situ LIMA graft parameters measured by CDUS studies. CDUS is a useful functional noninvasive tool for the preoperative screening and postoperative follow-up of patients with in situ LIMA bypass.


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