Blood flow reversal from the external into the internal carotid artery—New insights into the hemodynamics at the carotid bifurcation

Meyer, P

doi:10.1002/brb3.1139

Cited by 12 publications

(7 citation statements)

References 14 publications

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“…One reason could be that some people had blood flow reflux from external carotid artery to internal carotid artery. Previous study also described the physiological phenomenon 27 . And another reason might be some complex flow had longer duration from the middle of systole to the early even middle of diastole.…”

Section: Discussionmentioning

confidence: 84%

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Blood Flow Turbulence Quantification of Carotid Artery With a High‐Frame Rate Vector Flow Imaging

Dong

Shen

Song

et al. 2022

J of Ultrasound Medicine

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Objectives To assess the feasibility and performance of Turbulence (Tur) index as a quantitative tool for carotid artery flow turbulence; to detect and compare the blood flow patterns of common carotid artery (CCA) and carotid bulb (CB) at different ages and cardiac phases in healthy adults, and thus interpret the evolvement of etiology difference between CCA and CB. Methods Carotid flow characteristics of 40 healthy volunteers were evaluated quantitatively by a high‐frame rate vector flow imaging. Three types of flow patterns were defined depending on the distributive range of complex flow during systole in CB. Comparison of mean Tur value in CCA and CB at different age groups and cardiac phases was performed. And the correlation between Tur value and the diameter ratio of proximal internal carotid artery to common carotid artery (DRpro‐ica/cca) was tested. Results Mean Tur values in CB were remarkably higher than that in CCA, whether during systole or diastole (P < .001). Meanwhile Tur values in CB during systole were significantly higher than that during diastole (P < .001). Flow complexity of CB showed variations among 40 participants especially in systole, whereas the flow pattern of CCA was relatively consistent. Mean Tur values were positively correlated with DRpro‐ica/cca in CB (ρ = 0.69, P < .05). Conclusions V Flow imaging provided a reliable method—Tur, for quantitative analysis of carotid blood flow. It had potential to be further applied in distinguishing complex hemodynamic characteristics in high‐risk people of carotid diseases for the risk stratification of cardiovascular events.

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Section: Discussionmentioning

confidence: 84%

“…Previous study also described the physiological phenomenon. 27 And another reason might be some complex flow had longer duration from the middle of systole to the early even middle of diastole. Secondly, the result could be associated with the variations of vascular curvature and diameter in CB.…”

Section: Discussionmentioning

confidence: 99%

Blood Flow Turbulence Quantification of Carotid Artery With a High‐Frame Rate Vector Flow Imaging

Dong

Shen

Song

et al. 2022

J of Ultrasound Medicine

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“…Zarins et al showed that atherosclerotic plaques tend to be located precisely in this region of predicted flow reversal 27 . In addition, Patrick et al reported that because of reversal flow in the CB, retrograde embolism from plaques in the proximal external carotid artery to the internal carotid artery plays a role in ischemic stroke 28 . Therefore, further research is necessary to focus on reversal flow.…”

Section: Discussionmentioning

confidence: 99%

Precise evaluation of blood flow patterns in human carotid bifurcation based on high‐frame‐rate vector flow imaging

Hong

Dong

Song

et al. 2023

J of Clinical Ultrasound

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Purpose To investigate the feasibility of high‐frame‐rate vector flow imaging (HiFR‐VFI) compared to ultrasound color Doppler flow imaging (CDFI) for precisely evaluating flow characteristics in the carotid bifurcation (CB) of presumed healthy adults. Methods Forty‐three volunteers were assessed for flow characteristics and their extensions using HiFR‐VFI and CDFI in CBs. The flow patterns were classified according to the streamlines in HiFR‐VFI and quantitatively measured using an innovative turbulence index (Tur‐value). Interobserver agreement was also assessed. Results HiFR‐VFI was consistent with CDFI in detecting laminar and nonlaminar flow in 81.4% of the cases; however, in 18.6% of the cases, only HiFR‐VFI identified the nonlaminar flow. HiFR‐VFI showed a larger extension of complex flow (0.37 ± 0.26 cm2) compared to CDFI (0.22 ± 0.21 cm2; p < 0.05). The flow patterns were classified into four types: 3 type‐I (laminar flow), 35 type‐II (rotational flow), 27 type‐III (reversed flow), and 5 type‐IV (complex flow). The Tur‐value of type‐IV (50.03 ± 14.97)% is larger than type‐III (44.57 ± 8.89)%, type‐II (16.30 ± 8.16)%, and type‐I (1.48 ± 1.43)% (p < 0.05). Two radiologists demonstrated almost perfect interobserver agreement on recognizing the change of streamlines (κ = 0.81, p < 0.001). The intraclass correlation coefficient of the Tur‐value was 0.98. Conclusion HiFR‐VFI can reliably characterize complex hemodynamics with quantitative turbulence measurement and may be an auxiliary diagnostic tool for assessing atherosclerotic arterial disease.

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“…Even small changes of the insonation angle lead to a considerable difference of the peak systolic velocity [ 17 ]. This might be overcome by new ultrasound techniques like vector flow imaging where the velocity measurement is independent of the insonation angle [ 18 , 19 ]. Overall, no single CDS criterion showed a perfect agreement neither between both sonographers nor compared with DSA.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the interrater and intermethod agreement of the German multiparametric ultrasound criteria for the grading of internal carotid artery stenosis

et al. 2020

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Purpose The interdisciplinary German guidelines for the diagnosis and treatment of internal carotid artery stenosis (ICAS) recommend a multiparametric approach for the sonographic grading of extracranial ICAS. The aim of this study is to evaluate the interrater and intermethod agreement of this elaborated sonographic approach with different angiographic modalities. Methods Patients with extracranial ICAS were examined twice with colour-coded duplex sonography (CDS) by two experienced vascular neurologists. Each of the ten criteria and the resulting stenotic value were assessed. Grading of ICAS based on the multiparametric ultrasound criteria was compared with different angiography modalities (magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography (DSA)). Results Seventy-four consecutive patients with 91 extracranial ICAS were recruited from our stroke unit and neurovascular outpatient clinic. Interrater agreement for each single ultrasound criterion ranged from moderate to excellent (for the peak systolic velocity). Concerning the absolute stenotic value of ICAS, an excellent agreement between both ultrasound examiners with an ICC of 0.91 (range 0.87–0.94; p < 0.001) was found. In 96% of ICAS, the difference between the stenotic values was ≤ 10%. Intermethod agreements between CDS and DSA, CTA, and MRA were also good for both sonographers. Conclusion Strictly adhering to the multiparametric “DEGUM ultrasound criteria”, we found an excellent interrater agreement and a good intermethod agreement compared with angiography for the sonographic grading of extracranial ICAS. Thus, multiparametric CDS is in particular suitable for the follow up of extracranial ICAS even when examinations are done by different sonographers.

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Blood flow reversal from the external into the internal carotid artery—New insights into the hemodynamics at the carotid bifurcation

Cited by 12 publications

References 14 publications

Blood Flow Turbulence Quantification of Carotid Artery With a High‐Frame Rate Vector Flow Imaging

Blood Flow Turbulence Quantification of Carotid Artery With a High‐Frame Rate Vector Flow Imaging

Precise evaluation of blood flow patterns in human carotid bifurcation based on high‐frame‐rate vector flow imaging

Evaluation of the interrater and intermethod agreement of the German multiparametric ultrasound criteria for the grading of internal carotid artery stenosis

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