A High Prevalence of Intracranial Stenosis in Patients with Coronary Artery Disease and the Diagnostic Value of Transcranial Duplex Sonography

Valaikienė, Jurgita; Ryliškytė, Ligita; Valaika, Arūnas; Puronaitė, Roma; Dementavičienė, Jūratė; Vaitkevičius, Arūnas; Badarienė, Jolita; Butkuvienė, Irena; Kalinauskas, Gintaras; Laucevičius, Aleksandras

doi:10.1016/j.jstrokecerebrovasdis.2018.12.023

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…In the present study, color-coded duplex sonography, MRA and invasive catheter angiography were used to assess the degree of stenosis in patients with coronary artery disease with satisfactory sensitivity and accuracy, as well as manageable readers' errors and diagnostic costs. The results were consistent with those of previous prospective studies (1,5). Catheter angiography provides excellent visualization but it is risky, invasive, expensive (15) and requires contrast agent injection (7).…”

Section: Discussionsupporting

confidence: 93%

“…For the diagnosis, the coronal planes were used for the middle cerebral artery. The M1 segment in the middle cerebral artery and the carotid siphon C1 and C5 segments were diagnosed on the bilateral sides (1).…”

Section: Methodsmentioning

confidence: 99%

“…The end-diastolic blood flow velocities, peak systolic blood flow velocities and mean blood flow velocities were recorded. The pulsatility index, resistance index and C1/ICA index were calculated for each vessel segment as per Equations i, ii and iii (1).…”

Section: Methodsmentioning

confidence: 99%

“…Intracranial stenosis may result in ischemic infarction (1) and is associated with a risk of ischemic stroke (2). Extracranial and intracranial carotid artery stenosis is common among symptomatic patients in China (3).…”

Section: Introductionmentioning

confidence: 99%

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Color‑coded duplex sonography vs. 3.0 Tesla magnetic resonance angiography for detection of intracranial stenosis of the internal carotid artery: A prospective cohort study

2019

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Hemodynamic changes may provide important information for clinical decision-making in internal carotid artery (ICA) stenosis. The degree of stenosis is responsible for the hemodynamic changes. For detection of intracranial stenosis, each diagnostic method has its own advantages and disadvantages. The goal of the present study was to compare the sensitivity and accuracy of color-coded duplex sonography with that of magnetic resonance angiography (MRA) for the detection of intracranial stenosis. Patients with 3 vessels and/or left stem coronary artery disease were subjected to transcranial and extracranial color-coded duplex sonography (n=998), MRA (n=998) and invasive catheter angiography (n=939). The degree of stenosis was defined according to the Warfarin-Aspirin Symptomatic Intracranial Disease methodology. A ≥50% reduction in artery diameter was considered as a positive obstructive lesion. The benefits of each imaging method were assessed by clinical decision-making analysis. Color-coded duplex sonography and MRA, had sensitivities of 0.935 and 0.957 and accuracies of 0.92 and 0.974, respectively, when using invasive catheter angiography as a gold standard. The number of false-positive obstructive lesions detected by MRA was significantly higher than that for color-coded duplex sonography (53 vs. 13, P<0.0001). Color-coded duplex sonography was able to detect an obstructive lesion in one single image for ICAs with ≥57% stenosis, while MRA was only capable of detecting an obstructive lesion in one single image for ICAs with ≥80% stenosis. In conclusion, color-coded duplex sonography is a reliable method for the detection of intracranial stenosis in patients with coronary artery disease.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Color‑coded duplex sonography vs. 3.0 Tesla magnetic resonance angiography for detection of intracranial stenosis of the internal carotid artery: A prospective cohort study

2019

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“…When combined, they may improve the diagnostic accuracy of intracranial artery stenosis [22]. A cross-sectional TCCD study on patients with advanced CAD showed that the asymptomatic intracranial stenosis rate was 63.6%, and the most affected region was the C1 segment of the ICA [23]. TCCD was concluded to be a reliable method and to help to predict events in patients with advanced CAD.…”

Section: Transcranial Doppler (Tcd) and Transcranial Color Doppler (Tccd)mentioning

confidence: 99%