Carotid Stenosis Assessment with Vector Concentration before and after Stenting

Brandt, Andreas Hjelm; Nguyen, Tin-Quoc; Gutte, Henrik; Carlsen, Jonathan Frederik; Moshavegh, Ramin; Jensen, Jørgen Arendt; Nielsen, Michael Bachmann; Hansen, Kristoffer Lindskov

doi:10.3390/diagnostics10060420

Cited by 10 publications

(7 citation statements)

References 36 publications

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“…Recently, high frame rate vector flow imaging (V Flow) has become available (9)(10)(11) and it is capable to quantitatively evaluate flow turbulence (11,12). Most published studies using V Flow have been investigations on carotid arteries for blood flow visualization, wall shear stress measurement and volume flow estimation, as well as in the assessment of arterial stenosis before and after carotid artery stenting (13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Quantitative Evaluation of Post-stenotic Blood Flow Disturbance in Canine Femoral Artery Stenosis Model: An Early Experience With Vector Flow Imaging

Zhao¹,

Zheng²,

Wang³

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveTo investigate the value of Vector Flow Imaging (V Flow) in the assessment of post-stenotic turbulence in the canine arterial stenosis model.Materials and MethodsCanine femoral artery stenosis models were established using ameroid constrictors in 12 beagle dogs. 50% and then 70% femoral artery stenoses were confirmed by selective femoral artery angiography. V Flow was used to measure femoral artery flow turbulence index (Tur) preoperatively as a baseline. After establishing of a 50% and then 70% stenoses, the Tur indices were recorded in the femoral artery at 1, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mm distal to the stenosis.ResultsBaseline Tur indices of normal canine femoral arteries were <1% in 11 of 12 cases (91.7%). Distal to a 50% stenosis, the Tur index (>1%) was recorded in 83.3–100% cases between 1 and 9 mm, 41.7–58.3% between 11 and 17 mm, and 16.7% at 19 mm. For a 70% stenosis, the Tur index (>1%) occurred in 81.8–100% cases between 1 and 17 mm distal to the stenosis, and 63.6% at 19 mm. The Tur index peaked around 7 mm or 2.3 times of the initial vessel diameter (3 mm) downstream for a 50% stenosis and 11 mm or 3.7 times of vessel diameter downstream for a 70% stenosis.ConclusionV Flow with Tur index measurement adds quantitative information of post-stenotic turbulence when assessing an arterial stenosis with ultrasound. Tur index of 1% seems a useful threshold for assessment of flow turbulence in this small sample study. Further studies with larger sample size are needed to evaluate the value of V Flow in clinical applications.

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Section: Introductionmentioning

confidence: 99%

Quantitative Evaluation of Post-stenotic Blood Flow Disturbance in Canine Femoral Artery Stenosis Model: An Early Experience With Vector Flow Imaging

Zhao¹,

Zheng²,

Wang³

et al. 2022

Front. Cardiovasc. Med.

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“…This study demonstrated the transvalvular vector concentration parameter to correlate strongly with catheter pressure differences before intervention after exclusion of an outlier without stenosis. Brandt et al 14 and Hansen et al 12 reported strong correlations between vector concentration and stenosis severity in carotid and femoral artery stenoses, and Saris et al 7 found increased flow complexity in diseased carotid arteries. However, their reference methods differed from this study, and the reported correlations may not be comparable.…”

Section: Discussionmentioning

confidence: 99%

Transthoracic Vector Flow Imaging in Pediatric Patients with Valvular Stenosis – A Proof of Concept Study

Nguyen

Bechsgaard

Schmidt

et al. 2021

Ultrasound Int Open

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Purpose Continuous wave Doppler ultrasound is routinely used to detect cardiac valve stenoses. Vector flow imaging (VFI) is an angle-independent real-time ultrasound method that can quantify flow complexity. We aimed to evaluate if quantification of flow complexity could reliably assess valvular stenosis in pediatric patients. Materials and Methods Nine pediatric patients with echocardiographically confirmed valvular stenosis were included in the study. VFI and Doppler measurements were compared with transvalvular peak-to-peak pressure differences derived from invasive endovascular catheterization. Results Vector concentration correlated with the catheter measurements before intervention after exclusion of one outlier (r=−0.83, p=0.01), whereas the Doppler method did not (r=0.49, p=0.22). The change in vector concentration after intervention correlated strongly with the change in the measured catheter pressure difference (r=−0.86, p=0.003), while Doppler showed a tendency for a moderate correlation (r=0.63, p=0.07). Conclusion Transthoracic flow complexity quantification calculated from VFI data is feasible and may be useful for assessing valvular stenosis severity in pediatric patients.

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“…Preliminary studies have indicated that VFI is more accurate, precise, and easier to operate than conventional spectral Doppler ultrasound. With VFI, grading of stenosis can be done by assessing flow complexity as shown for the ascending aorta, the carotid and femoral artery [ 4 ]. The angle independent velocity estimation opens up for real-time quantification of vortices found anywhere in the cardiovascular system, and preliminary VFI studies have concerned evaluations of vortex formation in the heart of newborns and adults, and in vessels of straight and complex geometries to understand and map the complex fluid dynamic.…”

Section: Ultrasoundmentioning

confidence: 99%

“…In this special edition both case series, original research, and reviews are presented. The topics cover various vascular geometries using ultrasound, CT, MRI, and angiography [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%