Comparison of transcranial and cervical continuous-wave Doppler in the evaluation of intracranial collateral circulation.

Bass, Arie; Krupski, William C.; Dilley, Ralph B.; Bernstein, Eugene F.; Otis, Shirley M.

doi:10.1161/01.str.21.11.1584

Cited by 16 publications

(6 citation statements)

References 21 publications

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“…There appeared to be no complications due to digital carotid compression in the present study, probably because healthy dogs were used. Similar results for its safety have been reported in human medicine (Padayachee and others 1986, Schneider and others 1988, Bass and others 1990). However, to avoid any associated problems, Bass and others (1990) recommended that compression should be of short duration to avoid ischaemic complications.…”

Section: Discussionsupporting

confidence: 87%

“…Changes in the arterial flow following haemodynamic changes or cardiopulmonary resuscitation (Fukushima and others 2000), and following the administration of drugs such as sufentanil (Werner and others 1991), propofol (Werner and others 1992) or diuretics (Seo and others 2005) have been evaluated. Although previous studies did not describe the compression manoeuvres used in dogs, transcranial Doppler combined with common carotid artery compression is part of the routine procedure during transcranial Doppler ultrasonographic investigations to identify the brain‐supplying arteries in human patients, and has been shown to be an accurate and reproducible method for the evaluation of cerebral ischaemia and intracranial collateral circulation (Padayachee and others 1986, Schneider and others 1988, Bass and others 1990).…”

Section: Discussionmentioning

confidence: 99%

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Effect of transient carotid artery compression during transcranial Doppler ultrasonography in dogs

et al. 2010

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Changes in blood flow in the arteries of the canine skull base following compression of the ipsilateral carotid artery were evaluated. Forty healthy conscious dogs were evaluated during examination in lateral recumbency. Using the temporal window, the rostral, middle and caudal cerebral arteries were evaluated. The basilar artery was studied through the suboccipital window. Following compression, the pulse Doppler signal was reduced or inverted when interrogating the rostral or middle cerebral artery, and no change was observed when the caudal cerebral artery or basilar artery was evaluated.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effect of transient carotid artery compression during transcranial Doppler ultrasonography in dogs

et al. 2010

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“…Collateral flow pathways are of special significance when planning for carotid revascularization procedures [31], because their adequacy is the main determinant of cerebral blood flow in patients with severe carotid stenosis [32] and following cross-clamping. Several TCD studies have assessed intracranial collateral flow [ 10,22,26,[33][34][35]. We found that our original TCD criteria were 100% sensitive and 92% specific in identifying retrograde flow through the OA, and that the specificity could not be improved by increasing the OA peak systolic velocity to -30 em/sec.…”

Section: Discussionmentioning

confidence: 88%

Transcranial Doppler Validation Pilot Study

Babikian

Sloan

Tegeler

et al. 1993

Journal of Neuroimaging

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The use of transcranial Doppler sonography (TCD) for the evaluation of patients with ischemic cerebrovascular disease remains controversial. This study was organized to gather preliminary data regarding the sensitivity and specificity of TCD when compared to cerebral angiography in detecting stenosing lesions and collateral flow patterns of the anterior cerebral circulation. Forty-two patients from six medical centers were prospectively enrolled. Each received cerebral angiography and TCD testing within 24 hours of each other. Based on TCD criteria established a priori, the results were first analyzed by a blinded investigator and then by computer. Computerized analyses were then repeated with modified criteria. Collateral flow through the anterior communicating and ophthalmic arteries was detected with sensitivities of 62% and 100%, and specificities of 98% and 92%, respectively. Internal carotid artery proximal and distal severe ( greater than 70%) stenoses were detected with sensitivities of 79% and 100% and specificities of 88% and 97%. Middle and anterior cerebral artery stenoses and middle cerebral artery occlusion were detected with specificities exceeding 98%; however, the data were insufficient to determine sensitivity. Computerized analyses did not permit improvement of sensitivity and specificity of the baseline criteria. The selected TCD criteria are highly specific in detecting intracranial stenoses and collateral flow patterns of the anterior circulation. The criteria have limited but acceptable sensitivity and specificity in detecting internal carotid artery origin severe stenoses, and are highly sensitive in detecting ophthalmic artery retrograde flow. A study with a larger sample is necessary to provide definitive guidelines for diagnosis.

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“…Unfortunately, the patient numbers of the transcranial Doppler studies are too small to make a reliable comparison with our data. 19,30 Moreover, TCCD is considered a technique superior to conventional transcranial Doppler when exact measurements in small arterial segments are required. 16,31,32 It is of interest to compare our findings with the results of MR angiography, another new noninvasive technique for establishing the collateral integrity of the circle of Willis.…”

Section: Discussionmentioning

confidence: 99%

Collateral Variations in Circle of Willis in Atherosclerotic Population Assessed by Means of Transcranial Color-Coded Duplex Ultrasonography

Hoksbergen

Legemate

Ubbink

et al. 2000

Stroke

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Background and Purpose-Transcranial color-coded duplex ultrasonography combined with common carotid artery (CCA) compression can be used to assess the collateral function of the circle of Willis. The aim of this study was to assess the unknown fraction of hemodynamic functional anterior and posterior communicating arteries (AcoA and PcoA, respectively) in an atherosclerotic population with no cerebrovascular symptoms. Methods-In 76 patients with a mean age of 61 (35 to 89) years, the blood flow velocity changes in the precommunicating parts (A1 and P1, respectively) of the anterior and posterior cerebral arteries were measured during CCA compression. The AcoA was defined as functional if blood flow was reversed in the ipsilateral A1 and enhanced in the contralateral A1 during CCA compression. The PcoA was defined as functional if the flow velocity in the P1 was enhanced Ͼ20% during ipsilateral CCA compression. Results-It was possible to assess cross flow through the anterior part of the circle of Willis in 95% of the subjects. Failure of this collateral pathway was caused by a hypofunctional AcoA in 4% and a hypofunctional A1 in 1% of the subjects. Anomalies in the posterior part of the circle of Willis hampering collateral flow from the basilar to the internal carotid artery were found in 45% of the hemispheres. Thirty-eight percent of PcoAs were hypofunctional, and 7% of the posterior cerebral arteries had a persistent fetal anatomy. Conclusions-We found that in subjects with no cerebrovascular symptoms, the anterior collateral pathway of the circle of Willis was nearly always functional. In contrast, the posterior collateral pathway was nonfunctional in almost half of the total number of hemispheres. Comparing these basic data with data from patients with cerebral ischemic disease might further help to elucidate the importance of the collateral capacity of the circle of Willis.

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Comparison of transcranial and cervical continuous-wave Doppler in the evaluation of intracranial collateral circulation.

Cited by 16 publications

References 21 publications

Effect of transient carotid artery compression during transcranial Doppler ultrasonography in dogs

Effect of transient carotid artery compression during transcranial Doppler ultrasonography in dogs

Transcranial Doppler Validation Pilot Study

Collateral Variations in Circle of Willis in Atherosclerotic Population Assessed by Means of Transcranial Color-Coded Duplex Ultrasonography

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