Usefulness of Intravascular Doppler Flow Measurements in Cerebral Endovascular Treatment

Abstract

<jats:p> Measurement of cerebral blood flow in cerebral endovascular procedures is useful for the assessment of treatment effects. We used transcranial Doppler sonography (TCD) and Doppler guide wires (SmartWire®, Cardiometrics Co.) in intravascular treatment. </jats:p><jats:p> The cases were 6 brain arteriovenous malformations (AVM), 2 carotid cavernous fistulas (CCF), 2 facial angiomas, and 2 carotid stenoses. </jats:p><jats:p> Intravascular cerebral blood flow measurements with the SmartWire were performed during the endovascular procedure. TCD was used pre- and post-endovascular treatment, and velocity, pulsatility index (PI) and resistance index (RI) were compared with the SmartWire. </jats:p><jats:p> For both TCD and SmartWire, blood velocity of the main artery decreased, and PI and RI were improved after embolisation of AVM. </jats:p><jats:p> In angioplasty cases, post stenotic flow velocity, as measured by SmartWire, was improved, and the flow of MCA measured with TCD was also improved after treatment. The SmartWire is useful to assess cerebral blood flow changes during the neuroendovascular procedure. </jats:p><jats:p> Combined with repeated follow up with TCD, Doppler flow measurements are useful to assess the effect of endovascular treatment. </jats:p>

Transcranial Doppler Ultrasound: A Review of the Physical Principles and Major Applications in Critical Care

“…(Discussion of peri-procedural TCD applications, including the evaluation of extracranial carotid disease [11, 36, 42], intracranial stenosis [6, 43–45] and monitoring in carotid endarterectomy [14, 35, 46–51] and other neurovascular [52–55] and cardiac procedures [56–58] are beyond the scope of this paper and the reader is directed to the referenced articles. )…”