Clinical Application of Transcranial Color Doppler Ultrasound in Carotid Endarterectomy

2021 ◽  
Vol 11 (2) ◽  
pp. 437-444
Author(s):  
Yicheng Huang ◽  
Junyan Peng ◽  
Rong Mi ◽  
Zhenxing Yang ◽  
Linquan Zhu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Color Doppler ◽  
Arterial Disease ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Ischemic Cerebrovascular Disease ◽  
Artery Disease ◽  
Transcranial Color Doppler

Ischemic cerebrovascular diseases are important duet to the high incidence, disability, mortality, and recurrence. Intracranial arterial stenosis caused by atherosclerosis is an important pathological basis of ischemic cerebrovascular disease. Therefore, convenient, non-invasive, cheap and accurate screening methods have become the goal of everyone's joint efforts. The purpose of this study was to investigate the value of transcranial Doppler in judging arterial stenosis, and to explore the best cut-off point for assessing the blood flow velocity of middle cerebral artery disease and the compensation of the posterior branch of middle cerebral artery disease. Using retrospective analysis, binomial logistic regression analysis was performed on risk factors related to ischemic cerebrovascular disease. The 60 patients with intracranial stenosis were selected for TCD (Transcranial Color Doppler) and CTA (Computed Tomography Angiography) examinations within one week of onset. CTA was used as the diagnostic criterion to analyze the accuracy of TCD in the diagnosis of intracranial arterial disease. ROC (Receiver Operating Characteristic) curve was used to determine the optimal cutoff point of blood flow velocity for MCA (Middle Cerebral Artery) lesions. TCD has high specificity and sensitivity in the diagnosis of intracranial arterial disease, and it can be widely used in clinic as a simple, convenient and cheap diagnostic method for screening intracranial arterial stenosis.

scholarly journals Transcranial duplex ultrasound monitoring of intracranial arterial stenosis treated with ELUTAX “3” drug-eluting balloon

2020 ◽  
Vol 26 (6) ◽  
pp. 800-804
Author(s):  
Elena Elvira Soler ◽  
Blanca Serrano Serrano ◽  
Nicolás López Hernández ◽  
Natasha Guevara Dalrymple ◽  
Sarai Moliner Castellano ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Transcranial Doppler ◽  
Arterial Stenosis ◽  
Transcranial Ultrasound ◽  
Mean Flow ◽  
Intracranial Arterial Stenosis ◽  
Ultrasound Monitoring ◽  
Drug Eluting ◽  
Drug Eluting Balloon

We report the results of transcranial ultrasound monitoring in three patients with intracranial arterial stenosis of the middle cerebral artery treated with the only drug-eluting balloon certificated for intracranial use in highly symptomatic intracranial arterial stenosis, ELUTAX “3” (AR Baltic Medical). We performed transcranial Doppler ultrasounds 24 h, 72 h, 10 days, 15 days and 30 days after the angioplasty, thereby measuring mean flow velocity (MFV) in the maximum stenosis area in patients with symptomatic steno-occlusive disease of the middle cerebral artery treated with ELUTAX “3”. Two patients were treated during mechanical thrombectomy (MT) due to acute ischemic stroke and one patient was treated on elective basis due to symptomatic pre-occlusive stenosis, with recurrent transient ischemic attacks (TIAs) refractory to medical therapy. In Case 1, the first transcranial Doppler ultrasounds evidenced MFV of 348 cm/s, with progressive MFV reduction until 15 days post-treatment, with MFV of 177 cm/s. In Case 2, 24 h after angioplasty had an MFV of 258 cm/s, decreasing to 103 cm/s at 30 days. Case 3 had an MFV of 436 cm/s before angioplasty that immediately decreased after the procedure to 364 cm/s, with a final MFV of 260 cm/s at 30 days. We have recorded a progressive MFV reduction in intracranial arterial stenosis, with better outcomes in patients treated during MT. In our experience, the use of ELUTAX “3” for the treatment of symptomatic intracranial arterial stenosis achieves a progressive improvement of stenosis, evident in the first weeks, to a higher extent in cases of occlusive thrombosis. More studies are needed to provide more information about this device.

Abstract WP48: Relationship of Cerebral Blood Flow by Pseudo-continuous Arterial Spin Labeling and Stenosis in Middle Cerebral Artery Territory in Patients Evaluated for Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Eric Lai ◽  
Raja Rizal Azman Raja Aman ◽  
Hui Zhang ◽  
Pui-Wai Chiu ◽  
Queenie Chan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Cerebral Artery ◽  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Arterial Stenosis ◽  
Vascular Territory

Purpose: Correlation of arterial stenosis with cortical and subcortical cerebral blood flow (CBF) in the middle cerebral artery (MCA) territory. Methods: 126 patients with acute cerebrovascular symptoms from March to June 2015 underwent MRI and MR Angiography (MRA) in a University hospital using a 3.0 Tesla scanner. Sequences included T1W, T2W, FLAIR, DWI, MRA, Pseudocontinuous Arterial Spin Labeling (pcASL, post-labeling delay 1.525 s). 13 patients (corrupted pcASL data) were excluded, with 113 patients (mean age: 67.74±14.19) evaluated (61 acute ischemic stroke, 52 patients transient ischemic attack). Institutionally developed software was used to determine CBF. MCA stenosis was graded into 4 categories by a neuroradiologist: 0 (no stenosis), 1 (mild <50%), 2 (moderate 50-70%) and 3 (severe >70%). Mean and standard deviation of MCA categories (leptomeningeal and perforating) CBF and corresponding degree of MCA stenosis were measured. Spearman correlation coefficients between CBF of cortical and subcortical regions and degree of MCA stenoses were calculated using SPSS (version 23.0). Results: The table showed the descriptive statistics. There was significant correlation between CBF of cortical region of MCA vascular territory and degree of stenosis of MCA in both left (r s = -0.296, p =0.001) and right (r s = -0.306, p =0.001) side. In the contrary, there was no correlation between subcortical CBF of MCA vascular territory and degree of stenosis of MCA in both sides. Conclusion: pcASL is a feasible non-invasive method to measure CBF in clinical setting. In MCA territory, the cortical blood flow correlated (fairly) with large vessel stenosis but not subcortical flow. We conclude that cortical CBF correlated with large artery stenosis, though being attenuated by collateral blood supply. No such relationship in subcortical CBF might be due to differential grey and white matter CBF flow, variable MCA stenotic location, and perforators originating from other territories.

scholarly journals Transvaginal color Doppler study of middle cerebral artery blood flow in early normal and abnormal pregnancy

1992 ◽  
Vol 2 (6) ◽  
pp. 424-428 ◽  
Author(s):  
A. Kurjak ◽  
M. Predanic ◽  
S. Kupesic-Urek ◽  
B. Funduk-Kurjak ◽  
V. Demarin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Color Doppler ◽  
Artery Blood Flow ◽  
Abnormal Pregnancy ◽  
Doppler Study

scholarly journals Ozone Therapy on Cerebral Blood Flow: A Preliminary Report

2004 ◽  
Vol 1 (3) ◽  
pp. 315-319 ◽  
Author(s):  
Bernardino Clavo ◽  
Luis Catalá ◽  
Juan L. Pérez ◽  
Victor Rodríguez ◽  
Francisco Robaina
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Color Doppler ◽  
Autologous Blood ◽  
Flow Quantification ◽  
Ozone Therapy ◽  
Doppler Study ◽  
Diastolic Velocity ◽  
The Common

Ozone therapy is currently being used in the treatment of ischemic disorders, but the underlying mechanisms that result in successful treatment are not well known. This study assesses the effect of ozone therapy on the blood flow in the middle cerebral and common carotid arteries. Seven subjects were recruited for the therapy that was performed by transfusing ozone-enriched autologous blood on 3 alternate days over 1 week. Blood flow quantification in the common carotid artery (n= 14) was performed using color Doppler. Systolic and diastolic velocities in the middle cerebral artery (n= 14) were estimated using transcranial Doppler. Ultrasound assessments were conducted at the following three time points: 1) basal (before ozone therapy), 2) after session #3 and 3) 1 week after session #3. The common carotid blood flow had increased by 75% in relation to the baseline after session #3 (P< 0.001) and by 29% 1 week later (P= 0.039). In the middle cerebral artery, the systolic velocity had increased by 22% after session #3 (P= 0.001) and by 15% 1 week later (P= 0.035), whereas the diastolic velocity had increased by 33% after session #3 (P< 0.001) and by 18% 1 week later (P= 0.023). This preliminary Doppler study supports the clinical experience of achieving improvement by using ozone therapy in peripheral ischemic syndromes. Its potential use as a complementary treatment in cerebral low perfusion syndromes merits further clinical evaluation.

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