Safety and Tolerability of SonoVue® in Patients with Large Artery Anterior Circulation Acute Stroke

Baracchini, Claudio; Viaro, Federica; Favaretto, Silvia; Palmieri, Anna; Kulyk, Caterina; Causin, Francesco; Farina, Filippo; Ballotta, Enzo

doi:10.1111/jon.12416

Cited by 6 publications

(3 citation statements)

References 35 publications

(81 reference statements)

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“…According to a 2016 study on patients with ischemic stroke, SonoVue did not cause any serious adverse effects, and only 6.5% of patients had mild or transient adverse effects. SonoVue is also safe in patients with acute stroke [23]. However, microbubble administration can be disrupted if the scanning is continued and in a single plane or if the acoustic power is not at the recommended level (less than 1%).…”

Section: Discussionmentioning

confidence: 99%

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

et al. 2019

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Patient: Male, 59 Final Diagnosis: Amoebic liver abscess Symptoms: Acute abdomen • dispnoea Medication: — Clinical Procedure: Percutaneous CT guided drainage Specialty: Surgery Objective: Rare disease Background: E. histolytica liver abscess results from extra-intestinal diffusion of amebiasis, which is responsible for up 100 000 deaths per annum, placing it second only to malaria in mortality. Currently, the criterion standard for the diagnosis of liver abscesses is ultrasound, but CEUS (contrast-enhanced ultrasound) is emerging as a more accurate method for liver study, and it could be more accurate than ultrasound and non-invasive compared to CT. Case Report: A white man (59 years old) with a 2-day history of dyspnea, acute abdominal pain in right upper quadrant, and raised inflammatory markers was admitted to a second-level Emergency Department in Rome (Italy). He reported several trips to tropical areas many years before, during which he ingested non-potable water and became infected with Entamoeba histolytica . This was treated medically with success. After administration of antibiotics (meropenem and metronidazole), a liver CEUS (contrast-enhanced ultrasonography) with administration of SonoVue (sulphur hexafluoride microbubbles) confirmed a giant liver abscess (15×16 cm). One day later, CT-guided drainage was performed without complications and the patient was discharged on the 25 th post-procedure day, with improved blood results. Conclusions: Acute abdominal pain can be caused by a variety of diseases, but a diagnosis of parasitic abscess should not be overlooked in non-endemic Western countries. CEUS is a new, promising, and more accurate technique that can be utilized to recognize liver abnormalities, including abscesses; however, retrospective population-wide studies are necessary to define the differential diagnoses.

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Section: Discussionmentioning

confidence: 99%

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

et al. 2019

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“…26 The injection can be repeated if necessary, and this ultrasound contrast agent can be safely administered in stroke patients with inadequate ABW. 31 However, it has been previously suggested that SONOVUE injection can lead to an artificial increase in cerebral blood flow velocity. 27,32 It has also been previously suggested that the artificial increase in cerebral blood flow velocity may be counteracted by reducing Doppler gain.…”

Section: Ultrasound Exploration Methodsmentioning

confidence: 99%

Detection of moderate to severe middle cerebral artery atherosclerotic stenosis in stroke patients: Transcranial color-coded duplex sonography versus computed tomography angiography

Toudou-Daouda,

Chausson,

Smadja

et al. 2023

Ultrasound

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Background: Intracranial atherosclerotic stenosis is a common cause of ischemic cerebrovascular events and is associated with a high risk of stroke recurrence. This study aimed to assess the diagnostic accuracy of transcranial color-coded duplex sonography for moderate-to-severe middle cerebral artery stenosis in stroke patients. Methods: A retrospective analysis was carried out, including 31 patients aged ⩾18 years hospitalized for ischemic cerebrovascular event in whom middle cerebral artery stenosis ⩾30% was identified on computed tomography angiography. Transcranial color-coded duplex sonography findings were compared to the degree of stenosis blindly identified on the computed tomography angiography used as the reference method. Results: Overall, 27 patients had M1 stenosis and the other 4 had M2 stenosis. To detect M2 stenosis ⩾ 50% and ⩾ 70%, stenotic to pre-stenotic ratio ⩾ 2 and ⩾ 3 had a sensitivity of 100%, respectively. To detect M1 stenosis ⩾ 70%, peak systolic velocity ⩾ 300 cm/s had a sensitivity of 53.8% and specificity of 85.7% with area under the receiver-operating characteristic curve of 0.753 (95% confidence interval: 0.568–0.938; p = 0.026), and stenotic to pre-stenotic ratio ⩾ 3 had a sensitivity of 84.6% and a specificity of 78.6% (area under the curve = 0.854; 95% confidence interval: 0.707–1; p = 0.002). Middle cerebral artery/anterior cerebral artery velocity ratio < 0.7 had a sensitivity of 57.1% and specificity of 90% to detect dampened pre-stenotic flow in middle cerebral artery secondary to downstream M1 stenosis ⩾ 70% (area under the curve = 0.800; 95% confidence interval: 0.584–1; p = 0.040). This study showed that stenotic to pre-stenotic ratio ⩾ 3 was more sensitive than peak systolic velocity ⩾ 300 cm/s to screen M1 stenosis ⩾ 70%. Middle cerebral artery/anterior cerebral artery ratio < 0.7 was a good indirect sign to detect dampened pre-stenotic flow due to M1 stenosis ⩾ 70%.

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“…TCCS has some advantages in diagnosing intra-axial intracranial hematomas (intraparenchymal hematomas), extra-axial intracranial hematomas (epidural and subdural hematomas), brain midline shift, hydrocephaly, brain tumors, cerebral aneurysms, and arteriovenous malformations [21]. Although real-time dynamic morphological information is achieved via color or power Doppler ow imaging of TCCS [23], it has been reported that only 55-80% of basal cerebral arteries can be determined via unenhanced TCCS [24].…”

Section: Introductionmentioning

confidence: 99%

Transcranial Color-Coded Duplex Sonography and Digital Subtraction Angiography in Acute Stroke Patients

Assarzadegan

Mohammadi

Lima

et al. 2021

Preprint

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Background: Stroke is the most common neurological disorder with a high incidence in Middle-eastern regions. We aimed to assess the diagnostic accuracy of transcranial color-coded duplex sonography (TCCS) for detection of cerebral artery stenosis compared to digital subtraction angiography (DSA) as a gold standard method.Methods: Eighty patients presenting with symptoms of cerebral ischemia were enrolled in the study. They were examined by color-coded Doppler and TCCS to determine stenosis of extracranial and intracranial arteries, respectively. DSA was performed 24-48 hours after the initial examination. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of TCCS in comparison to DSA was calculated. The agreement between the two methods was determined by kappa statistics. Results: Eighty patients (60% male, 40% female) with a mean age of 61.32±12.6 years were included. In 65% of cases, pathology in carotid artery was responsible for ischemia. We did not observe any abnormalities in the anterior cerebral artery (ACA), posterior cerebral artery (PCA) as well as basilar artery (BA). The agreement between TCCS and DSA in various arterial vessels were 0.9 for common carotid artery (CCA), 0.86 for internal carotid artery (ICA), 0.78 for middle cerebral artery (MCA), and 0.86 for vertebral artery (VA). The sensitivity, specificity, PPV, NPV, accuracy, and kappa value of TCCS for detection of stenosis regarding the arterial segments were 84.8%, 81%, 92.6%, 65.4%, 83.8, and 0.71, respectively. Conclusion: TCCS is a valuable, non-invasive, and repeatable method to investigate cerebral artery stenosis with high diagnostic accuracy.

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Safety and Tolerability of SonoVue® in Patients with Large Artery Anterior Circulation Acute Stroke

Abstract: According to our study, SonoVue® can be safely administered to acute ischemic stroke patients with suspected anterior circulation LAO and/or inadequate temporal bone window.

Cited by 6 publications

References 35 publications

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

Detection of moderate to severe middle cerebral artery atherosclerotic stenosis in stroke patients: Transcranial color-coded duplex sonography versus computed tomography angiography

Transcranial Color-Coded Duplex Sonography and Digital Subtraction Angiography in Acute Stroke Patients

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