Extracranial-Intracranial Bypass to Reduce the Risk of Ischemic Stroke in Intracranial Aneurysms of the Anterior Cerebral Circulation: A Systematic Review

Schaller, Bernhard

doi:10.1016/j.jstrokecerebrovasdis.2008.03.010

Cited by 53 publications

(38 citation statements)

References 78 publications

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“…DUS is the primary non-invasive imaging method for evaluation of ICA stenosis and is widely used in clinical practice [19] . It involves the use of doppler and color-doppler techniques [20,22] , and is often the only diagnostic method used to determine the degree and extent of carotid artery stenosis, to the point that this imaging modality is increasingly becoming the only examination performed before surgical intervention. Previous investigations have shown that 70% to 99% angiographic stenosis can be excluded by DUS with sensitivity as high as 98% [23] .…”

Section: Discussionmentioning

confidence: 99%

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Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

Gioia

Mangiacapra

Sedati

et al. 2016

Med Imaging Interv Radiol

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Carotid disease is a major cause of cerebrovascular events. Risk is proportional to the extent and severity of atherosclerosis. Aim of this study was to assess the correlation between 64-multi-detector-row computed-tomography angiography (MDCTA) and Doppler ultrasound peak-systolic-velocity (DUS-PSV) in the quantification of stenosis. 116 consecutive patients were included; it was calculated the degree of carotid stenosis with the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method using MDCTA and DUS-PSV. MDCTA measurements of stenosis ranged from 35% to 95% (mean 67±16%). DUS-PSV ranged from 102 to 600 cm/s (mean 262±112 cm/s). A moderate correlation (r 2 = 0.427) was found between MDCTA-NASCET stenosis and PSV values. At ROC curve analysis, PSV could significantly discriminate between stenoses ≥70% and <70% at MDCTA-NASCET measurement, with area under the curve of 0.807 (p<0.0001). PSV value ≥230 cm/s was identified as optimal cutoff to predict stenosis ≥70% at MDCTA, with a sensitivity of 71%, specificity of 83%, negative predictive value of 67% and positive predictive value of 82%. We found a reasonable concordance between MDCTA and DUS-PSV in quantifying carotid stenosis. PSV value of 230 cm/s is a reliable threshold to predict a >70% stenosis of MDCTA.Keywords: Carotid; Doppler; MDCTA; Ultrasound To cite this article: Giuseppe Di Gioia, et al. Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis.

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Section: Discussionmentioning

confidence: 99%

“…The wall filter was 100-150 Hz on average, the pulse repetition frequency was adjusted<1000 Hz (in most patients 500 Hz, depending on the flow characteristics). The color gain was selected just as high 23 (20) as it was necessary to avoid overwriting artefacts (Figure 2). …”

Section: Dus Techniquementioning

confidence: 99%

Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

Gioia

Mangiacapra

Sedati

et al. 2016

Med Imaging Interv Radiol

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“…Interestingly, experimental studies suggest that ischemic preconditioning and postconditioning activate the same signaling pathway at the time of reperfusion, thereby offering a common target for neuroprotection [12]. The pharmacologic recruitment of this signaling pathway at the time of cerebral reperfusion might allow one to harness the neuroprotective potential of ischemic preconditioning and postconditioning and therefore substantially improve the outcome in extracranial-intracranial bypass and neurovascular surgery [3,4,24,25].…”

Section: Neuroprotective Potential Of Postconditioningmentioning

confidence: 99%

“…The mechanisms of brain ischemia include glutamate excitoxicity, calcium toxicity, free radicals, nitric oxide and inflammatory reactions, as well as dysfunctions of endoplasmic reticulum and mitochondrion [1][2][3][4]. These injury cascades are interconnected in complex ways, thus it is hard to compare their pathogenic importance in ischemia models [5].…”

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confidence: 99%

Postconditioning: a new or old option after ischemic stroke?

Sandu

Schaller

2010

Expert Review of Cardiovascular Therapy

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“…3) However, further studies showed that this approach is effective in selected patients, especially in those with severe hemodynamic insufficiency. 5,8,9,12,15) The Japanese EC-IC Bypass Trial (JET Study) demonstrated the efficacy of superficial temporal artery (STA) to MCA anastomosis (STA-MCA anastomosis) for preventing new stroke in occlusive ICA and MCA diseases. 9) However, the effect of STA-MCA anastomosis may be inadequate because poor blood flow in the STA leads to insufficient flow to the MCA in patients with ICA occlusion and coexisting severe stenosis of the ipsilateral external carotid artery (ECA).…”

Section: Introductionmentioning

confidence: 99%

External Carotid Artery Stenting and Superficial Temporal Artery to Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion With External Carotid Artery Severe Stenosis

Oku

Nogami

Koizumi

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis may have inadequate effects in patients with internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA), because poor blood flow in the STA leads to insufficient flow to the MCA. In these patients, dilation of the stenotic ECA is required to improve the blood flow in the STA before STA-MCA anastomosis. A 71-year-old man presented with left hemiparesis and dysarthria. Magnetic resonance imaging revealed an old watershed infarction in the right cerebral hemisphere. Right carotid angiography showed right ICA occlusion and severe ipsilateral ECA stenosis. Single photon emission computed tomography (SPECT) demonstrated severe hemodynamic insufficiency in the right MCA territory. Instead of endarterectomy of the ECA, angioplasty and stenting (CAS) for ECA was performed to ensure adequate blood flow in the STA, due to the history of myocardial infarction and bifurcation of the common carotid artery at a high level (C2 level). Then STA-MCA anastomosis was performed 1 month later. Postoperative SPECT demonstrated marked improvement of hemodynamic insufficiency in the right MCA territory. After treatment, the patient had no ischemic events. This case suggests external CAS together with STA-MCA anastomosis is a good therapeutic option for a patient with symptomatic ICA occlusion and severe stenosis of the ipsilateral ECA if external CEA is difficult to perform.

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Extracranial-Intracranial Bypass to Reduce the Risk of Ischemic Stroke in Intracranial Aneurysms of the Anterior Cerebral Circulation: A Systematic Review

Cited by 53 publications

References 78 publications

Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

Postconditioning: a new or old option after ischemic stroke?

External Carotid Artery Stenting and Superficial Temporal Artery to Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion With External Carotid Artery Severe Stenosis

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