Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder

Itoh, S.; Suda, Kenji; Kishimoto, Shintaro; Nishino, Hiroshi; Kudo, Yoshiyuki; Iemura, Motofumi; Teramachi, Yozo; Matsuishi, Toyojiro; Yagi, Hiroshi

doi:10.1017/s1047951110001733

Cited by 11 publications

(18 citation statements)

References 12 publications

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“…[84][85][86] An emerging area for the use of transcranial Doppler sonography is perioperatively in children with congenital heart disease. [87][88][89][90][91][92] Cheng et al 90 measured flow velocities intraoperatively through 18 hours after cardiopulmonary bypass in 100 infants with congenital cardiac disease who underwent biventricular repair.…”

Section: Other Applicationsmentioning

confidence: 99%

“…Additionally, recent studies have found that nearly all children undergoing transcatheter closure of atrial septal defects had microembolic signals during the procedure. 91,92 In 24 chil- . Transcranial Doppler waveform from the right middle cerebral artery in an 11-month-old child with acute liver failure and right intraparenchymal hemorrhage who met clinical criteria for brain death.…”

Section: Other Applicationsmentioning

confidence: 99%

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Transcranial Doppler Sonography in Pediatric Neurocritical Care

LaRovere

O’Brien

2015

J of Ultrasound Medicine

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Transcranial Doppler sonography is a noninvasive, real-time physiologic monitor that can detect altered cerebral hemodynamics during catastrophic brain injury. Recent data suggest that transcranial Doppler sonography may provide important information about cerebrovascular hemodynamics in children with traumatic brain injury, intracranial hypertension, vasospasm, stroke, cerebrovascular disorders, central nervous system infections, and brain death. Information derived from transcranial Doppler sonography in these disorders may elucidate underlying pathophysiologic characteristics, predict outcomes, monitor responses to treatment, and prompt a change in management. We review emerging applications for transcranial Doppler sonography in the pediatric intensive care unit with case illustrations from our own experience.

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Section: Other Applicationsmentioning

confidence: 99%

Section: Other Applicationsmentioning

confidence: 99%

Transcranial Doppler Sonography in Pediatric Neurocritical Care

LaRovere

O’Brien

2015

J of Ultrasound Medicine

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“…Despite the broad range in underlying cardiac anatomy and physiology and procedures performed, pediatric studies have reported HITS occurring in “bursts” and clusters, often in association with a septal defect and/or right to left shunt . Maneuvers during catheterization for closure of atrial septal defects, namely, sheath placement, balloon sizing, and device placement, have been associated with HITS in children and young adults . Although not recorded for our study, other procedures in the catheterization laboratory, such as blood sampling and injection of drugs, fluids, and contrast agents, have also been reported to produce HITS .…”

Section: Discussionmentioning

confidence: 72%

“…27 Maneuvers during catheterization for closure of atrial septal defects, namely, sheath placement, balloon sizing, and device placement, have been associated with HITS in children and young adults. 23,28 Although not recorded for our study, other procedures in the catheterization laboratory, such as blood sampling and injection of drugs, fluids, and contrast agents, have also been reported to produce HITS. 26,29 Published studies vary in the TCD device and associated software used, Doppler settings, definition of HITS, calculation of HITS (manual and/or automated), and number of cerebral arteries insonated (Table 3).…”

Section: Discussionmentioning

confidence: 92%

Cerebral High‐Intensity Transient Signals during Pediatric Cardiac Catheterization: A Pilot Study Using Transcranial Doppler Ultrasonography

LaRovere

Kapur

McElhinney

et al. 2017

Journal of Neuroimaging

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“…TCD [4][5][6][7][8] has been widely used in clinical screening for clinical monitoring in recent years due to the characteristics of economy, non-invasiveness, repeatable check and so on. CDUS, [9][10][11] as one of the most popular vascular ultrasound techniques, has an irreplaceable advantage in the evaluation of the vascular wall, plaque morphology and stenosis of the extra cranial segment.…”

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confidence: 99%

The application value of TCD combined with CDUS in the large artery atherosclerosis

Wang¹,

Wang²,

Huang³

2015

DCC

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Objective: To explore the value of TCD and CDUS on diagnosis of large artery atherosclerosis. Methods: In our study, 90 patients who had been admitted to our hospital and diagnosed as LAA according to CISS typing were selected as the research object. A retrospective analysis was conducted, using CTA as golden standard for diagnoses of stenoses. Explore the risk factors of LAA, the reliability of TCD and CDUS in diagnosis of the stenosis and distribution of stenosis in each vessel. Results: Hypertension and type 2 diabetes are risk factors of LAA vascular stenosis. Middle cerebral artery stenosis detection by TCD carries the highest reliability (sensitivity 90.91%, specificity 97.89%, positive predictive value 96.15%, the negative predictive value was 94.9%, the positive likelihood ratio was 43.18, negative likelihood ratio 0.09, Kappa = 0.9). The consistency of TCD is as good as CTA in head and neck part. The negative coincidence rate was higher in the anterior circulation vessels (97.98%), followed by the coincidence rate of severe stenosis (95.23%). However, the detection rate of posterior circulation vessels positive, moderate and severe stenosis, mild stenosis gradually decreased by TCD. CDUS carries general reliability in detecting intracranial extracranial stenosis, the highest reliability in internal carotid artery (kappa 0.82), and the worst consistency in vertebral artery (kappa 0.38). The negative coincidence rate of CDUS in extracranial cerebrovascular stenosis was highest (97.22), followed by the overall compliance rate (91.55%). 242 branches of vascular stenosis were discovered in our study, among which intracranial artery stenosis 61.15% (148/242) is higher than that in extracranial artery 38.85% (90/242), ratio of moderate to severe stenosis is as high as 82. 23% (199/242). Intracranial artery stenosis in ICA is extremely common (51.11%, 46/90), and MCA is the common area of intracranial artery stenosis (37.16%, 55/148). Conclusions: (1) Hypertension, type 2 diabetes are risk factors for LAA stenosis. (2) TCD detection of intracranial vascular stenosis carries the best consistency, and reliability of MCA is the highest. In our search, MCA possesses the highest rate of stenosis, and negative coincidence rate by TCD examination was the highest, which could be used for screening method for stenosis. The reliability of TCD in diagnosis of moderate and severe stenosis was relatively better than mild stenosis. (3) CDUS detection of anterior circulation lesions is better than that of posterior circulation lesions. Evaluate effect on moderate and severe stenosis was better than that of mild one. The ratio of ICA stenosis was the highest, but the effect on VA was poor. (4) The incidence of intracranial vascular stenosis is more common than that of the intracranial vascular stenosis.

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Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder

Abstract: Transcatheter closure of atrial septal defect using the Amplatzer septal occluder produces microemboli, especially during device placement. To minimise the risk of systemic embolism, we must decrease the time for device manipulation.

Cited by 11 publications

References 12 publications

Transcranial Doppler Sonography in Pediatric Neurocritical Care

Transcranial Doppler Sonography in Pediatric Neurocritical Care

Cerebral High‐Intensity Transient Signals during Pediatric Cardiac Catheterization: A Pilot Study Using Transcranial Doppler Ultrasonography

The application value of TCD combined with CDUS in the large artery atherosclerosis

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