Diagnosis of Right-to-Left Shunt With Transcranial Doppler and Vertebrobasilar Recording

Sette, Massimo Del; Dinia, Lavinia; Rizzi, D; Sugo, Annalisa; Albano, Beatrice; Gandolfo, Carlo

doi:10.1161/strokeaha.106.479485

Cited by 50 publications

(41 citation statements)

References 26 publications

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“…The lower sensitivity of the VBC recording might depend on the lower amount of blood in the vertebrobasilar system (20% of the carotid circulation) [7] . A higher number of MB in the MCA than in VBC was also seen (number of MB at rest plus MB after VM = 16.1 8 13.4 vs. 10.6 8 7.2), according to previous observations [8] . A positive correlation between MB in the MCA and VBC was observed only for the medium and large shunts (k = 0.91, p !…”

supporting

confidence: 82%

Vertebrobasilar Recording with Contrast Transcranial Doppler in Right-to-Left Shunt Diagnosis

et al. 2008

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supporting

confidence: 82%

Vertebrobasilar Recording with Contrast Transcranial Doppler in Right-to-Left Shunt Diagnosis

et al. 2008

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“…The contrast medium was injected with a 21-gauge needle, possibly in the right antecubital vein. The contrast medium was a mixture of 9 ml of saline 0.9% mixed with 1 ml of air through two syringes (at least 10 passages) [15,16]. The velocity of injection was 2.5 ml/s [16].…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Patent Foramen Ovale in Ischaemic Stroke in Italy: Results of SISIFO Study

Consoli¹,

Paciaroni

Galati

et al. 2015

Cerebrovasc Dis

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Background: Although several authors have studied the association between patent foramen ovale (PFO) and ischaemic stroke, the matter is still controversial; few have suggested an association between cryptogenetic stroke and PFO, while others have denied this association. The aim of this study was to evaluate PFO prevalence in the whole ischaemic stroke population, independently from age and stroke subtypes and to identify the characteristics associated with the presence of PFO. Methods: SISIFO study was a multicenter, prospective, single-wave, cross-sectional survey conducted on consecutive patients with acute ischemic stroke admitted to selected clinical centres. Data regarding vascular risk factors were registered for each patient; all patients underwent computed tomography scan and/or magnetic resonance imaging of the brain; an electrocardiogram and standard laboratory blood tests were performed. A Doppler ultrasound study of extra-cranial arteries was performed too. The cases were classified according to TOAST and OCSP criteria. Each patient underwent transcranial Doppler or transcranial color-coded duplex sonography with bubble test as diagnostic tool for right-to-left-shunt. Where right-to-left shunt was detected, PFO presence was confirmed by echocardiography. Findings: 1,130 consecutive patients were included. We found a PFO in 247 (21.9%; 95% CI, 19.5-24.3%) patients; PFO was present in 23.5% of patients with cryptogenic stroke and in 21.3% of patients with stroke of known causes; this difference was not statistically significant. At the univariate analysis, decreasing age, hypertension, diabetes mellitus, and atrial fibrillation, and stroke characteristics such as NIHSS, OCSP and TOAST were predictors of PFO presence. At the multivariate analysis, we found a significant interaction between age and OCSP syndrome. Being LACI the reference category, the prevalence of PFO in PACI and POCI decreased significantly along with age, whereas there was no change in TACI. Conclusion: If any relationship exists between stroke and PFO, this is more likely in PACI and POCI at a younger age. Our results are consistent with recent findings that underline PFO alone must not be considered a significant independent predictor for stroke; so the presence of PFO alone doesn't permit rushed causal correlations or ‘therapeutic aggressiveness'.

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“…A previous study confirmed the possibility and reliability of MES monitoring at the basilar artery using basilar artery TCD recording for the diagnosis of right-to-left shunts. 17 Our study is the first to our knowledge to demonstrate the use of MES monitoring in patients with posterior circulation ischemia. MES monitoring at the basilar artery could be an alternative method in other research studying posterior circulation emboli, especially for subjects with an insufficient temporal acoustic window.…”

Section: Discussionmentioning

confidence: 71%

Microembolic Signals in Acute Posterior Circulation Cerebral Ischemia

Hwang

Kim²,

Hong³

et al. 2012

Stroke

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Background and Purpose-The clinical significance of microembolic signals (MES) in the posterior circulation remains unclear. The aim of this study was to investigate the sources and consequences of MES in acute posterior circulation cerebral ischemia. Methods-We evaluated a total of 140 consecutive patients (93 males, mean age 62.9 years) who had acute posterior circulation cerebral ischemia. The MES monitoring was conducted at the basilar artery through the suboccipital window for a 30-minute period. Results-MES were detected in 18 (12.9%) of the 140 patients. Clinical characteristics and laboratory data did not differ between the MES-positive and MES-negative groups. Intracranial vertebrobasilar artery (VBA) stenosis was independently associated with the presence of MES (odds ratio, 9.85; 95% confidence interval, 1.

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Diagnosis of Right-to-Left Shunt With Transcranial Doppler and Vertebrobasilar Recording

Cited by 50 publications

References 26 publications

Vertebrobasilar Recording with Contrast Transcranial Doppler in Right-to-Left Shunt Diagnosis

Vertebrobasilar Recording with Contrast Transcranial Doppler in Right-to-Left Shunt Diagnosis

Prevalence of Patent Foramen Ovale in Ischaemic Stroke in Italy: Results of SISIFO Study

Microembolic Signals in Acute Posterior Circulation Cerebral Ischemia

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