Rate of successful recording of blood flow signals in the middle cerebral artery using transcranial Doppler sonography.

Ito, Takuya; Matsumoto, Masayasu; Handa, Nobuo; Maeda, Hiroaki; Hougaku, Hidetaka; Hashimoto, Hiroyuki; Etani, Hideki; Tsukamoto, Yoshitane; Kamada, Takenobu

doi:10.1161/01.str.24.8.1192

Cited by 146 publications

(110 citation statements)

References 10 publications

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“…3,4 A demonstration of improved rates of ACA visualization by using a combination of the TBW and FBW is important because the insonation quality of Japanese patients with stroke via the TBW is inferior, especially in the ACA territory. Sonographic contrast may be useful for the FBW, to improve detection rates as demonstrated in the TBW.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In particular, an optimal TBW is difficult to apply in Asians. 3,4 Improving the detection rate of the anterior cerebral artery (ACA) by TCCS will increase the opportunity for such patients to undergo noninvasive and real-time evaluations at the bedside in general practice. In particular, Japanese patients will receive considerable benefits from an improved TCCS examination because pathologic changes often arise in the intracranial arteries, including the ACA.…”

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confidence: 99%

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Frontal Bone Window Improves the Ability of Transcranial Color-Coded Sonography to Visualize the Anterior Cerebral Artery of Asian Patients with Stroke: Fig 1.

Yoshimura¹,

Koga²,

Toyoda³

et al. 2009

AJNR Am J Neuroradiol

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SUMMARY:The frontal bone window (FBW) is a promising approach in evaluating the anterior cerebral artery. The goal of the present study was to determine the rates of detection of the basal cerebral arteries by using the FBW alone and a combination of the FBW with the temporal bone window (TBW) in 163 patients. The combined application improved detection rates of A1 (58.6% versus 46.0%, P ϭ .001) and A2 (43.6% versus 6.7%, P Ͻ .001) compared with the TBW alone.T ranscranial color-coded sonography (TCCS) is an established tool for evaluating intracranial cerebral arteries because it can identify and focus a sonographic beam on occluded sites. Although a proper bone window for TCCS is essential for detecting intracranial vascular lesions, the acoustic property of the standard approach via the temporal bone window (TBW) is limited in elderly and female patients.1,2 In particular, an optimal TBW is difficult to apply in Asians. 3,4 Improving the detection rate of the anterior cerebral artery (ACA) by TCCS will increase the opportunity for such patients to undergo noninvasive and real-time evaluations at the bedside in general practice. In particular, Japanese patients will receive considerable benefits from an improved TCCS examination because pathologic changes often arise in the intracranial arteries, including the ACA. 5,6 However, the ACA is more difficult to detect than the middle cerebral artery (MCA) through the TBW.7 Studies of a small cohort have indicated that this limitation could be overcome by an approach through the frontal bone window (FBW) to evaluate the postcommunicating segment (A2) of the ACA from a single center. 8 However, the utility of the FBW for Asian patients with stroke has not been determined. For Asians, TCCS via the FBW and the TBW might be equally disadvantageous.The present study determined the rate of detecting the basal cerebral arteries, including the ACA via the FBW alone and via the FBW combined with the TBW in Japanese patients with stroke. TechniqueA total of 163 consecutive Japanese patients (46 women; mean age, 69.5 Ϯ 11.4 years) with cerebrovascular disease were recruited. The detection rates of the main trunk of the MCA (M1), the precommunicating segment (A1) and A2 of the ACA, the precommunicating (P1) and the postcommunicating (P2) segments of the posterior cerebral artery (PCA) by TCCS through the FBW and TBW were evaluated by using a Sonos 5500 equipped with an S3 transducer (1.0 -3.0 MHz; Philips Medical Systems, Tokyo, Japan) or an iE33 with an S5-1 transducer (1.0 -5.0 MHz; Philips Medical Systems). Patients were randomly examined with 1 examination from each scanner. The TBW is located upward and forward of the earhole. The FBW consists of the lateral FBW located above the lateral aspect of the eyebrow and the paramedian FBW slightly lateral to the midline of the forehead (Fig 1). The most prominent vascular structure identified via the lateral FBW is A2 with blood flowing toward the probe. The ipsilateral A1 is color-coded with flow moving away from the probe, and ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Frontal Bone Window Improves the Ability of Transcranial Color-Coded Sonography to Visualize the Anterior Cerebral Artery of Asian Patients with Stroke: Fig 1.

Yoshimura¹,

Koga²,

Toyoda³

et al. 2009

AJNR Am J Neuroradiol

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“…27) The low penetration rate of TCD (<10%) in this study was thought to reflect the fact that most of the Japanese neurointerventionalists were neurosurgeons 8) and that insonation through the temporal bone window was limited in elderly Asian (Japanese) people. 28) There were two institutes that performed the X-ray angiography perfusion analysis using the application that was bundled with their angiography equipment. Both Terada et al 29) and Fujimoto et al 30) have reported finding that the X-ray angiography perfusion analysis for detecting hyperperfusion after revascularization during CAS was effective, and thus, can be considered to be a promising modality for detecting hyperperfusion.…”

Section: Resultsmentioning

confidence: 99%

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

Hayakawa

Matsumaru

Sakai

et al. 2017

NOUSHINKEI KEKKANNAI TIRYOU

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Objective: Cerebral hyperperfusion syndrome (CHS) including intracranial hemorrhage (ICH) is a serious complication after carotid artery stenting (CAS). Therefore, neurointerventionalists in Japan commonly stratify the risk for CHS preprocedurally in CAS candidates using various imaging tests that are available, and sometimes performed preventive methods against CHS, such as staged angioplasty (SAP), undersized-balloon angioplasty followed by delayed CAS. In the current study, we used a nationwide questionnaire survey to clarify the current status of the periprocedural management against CHS and the 30-day outcomes of patients with a high risk of CHS after undergoing CAS or endovascular carotid revascularization procedures, such as SAP or stand-alone angioplasty. This study specifically analyzed the data for the periprocedural management against CHS. Materials and Methods:Between June and August 2014, questionnaires were emailed to all of the neurointerventional specialists certified by the Japanese Society for Neuroendovascular Therapy (JSNET). If two or more specialist physicians belonged to an institute, a representative physician of the institute answered the questionnaire. This study focused on 14 items of the questionnaire that were directed at examining the preprocedural imaging tests done to evaluate the risk of CHS, the periprocedural management strategies used to prevent CHS, and the postprocedural imaging tests to detect hyperperfusion phenomenon, among others.Results: Replies were obtained from 154 institutes which represented 336 JSNET-certified neurointerventional specialists. Preprocedural imaging tests done to evaluate the risk of CHS were performed in 144 institutes (93.5%), with single-photon emission CT (SPECT) the most used modality in 88.2% of the institutes. Acetazolamide challenge was performed in 114 (89.8%) of 127 institutes that used preprocedural SPECT evaluation. Of the institutes performing preprocedural CHS-risk evaluation, general anesthesia was administered during the procedure in 44.4%, periprocedural

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“…For a long time, because the acoustic temporal bone window is more restricted in the elderly, and notably in women, TCCS was usually carried out on patients aged under 55 years (Itoh, T. et al, 1993). Thanks to the use of contrast enhancement, the sensitivity and specificity of diagnostic ultrasound imaging have been considerably improved (Droste, et al, 2002).…”

Section: Tccs Examination Of the M1 Segment 31 General Proceduresmentioning

confidence: 99%

The Role of TCCS in the Assessment of the Main Anatomical Patterns of the M1 segment of the Middle Cerebral Artery

Vuillier¹,

Tatu²,

Montiel³

et al. 2012

Sonography

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Rate of successful recording of blood flow signals in the middle cerebral artery using transcranial Doppler sonography.

Cited by 146 publications

References 10 publications

Frontal Bone Window Improves the Ability of Transcranial Color-Coded Sonography to Visualize the Anterior Cerebral Artery of Asian Patients with Stroke: Fig 1.

Frontal Bone Window Improves the Ability of Transcranial Color-Coded Sonography to Visualize the Anterior Cerebral Artery of Asian Patients with Stroke: Fig 1.

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

The Role of TCCS in the Assessment of the Main Anatomical Patterns of the M1 segment of the Middle Cerebral Artery

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