Ultrasound examination of carotid and vertebral arteries

Landwehr, P.; Schulte, Oliver; Voshage, Götz

doi:10.1007/s003300100963

Cited by 57 publications

(31 citation statements)

References 51 publications

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“…Stenoses of common, internal, and external carotid artery were measured as a reduction of luminal area and graded with consideration of all information from B-mode, pulsed-wave, and color-flow Doppler according to established criteria. 28,29 Anterior, middle, and posterior cerebral artery, vertebral and basilar arteries, and distal internal carotid artery were evaluated on the basis of peak systolic flow velocities by transcranial Doppler. Identification of the arteries and definition of normal velocities were based on published criteria.…”

Section: Preoperative Assessment Of Potential Sources Of Embolismmentioning

confidence: 99%

Silent and Apparent Cerebral Ischemia After Percutaneous Transfemoral Aortic Valve Implantation

Kahlert

Knipp²,

Schlamann³

et al. 2010

Circulation

477

297

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Background-The risk of stroke after transfemoral aortic valve implantation (TAVI) due to dislodgement and subsequent embolization of debris from aortic arch atheroma or from the calcified valve itself ranges between 2% and 10%. The rate of clinically silent cerebral ischemia is unknown but may be even higher. Methods and Results-Thirty-two patients who underwent TAVI with the use of a balloon-expandable (nϭ22) or self-expandable (nϭ10) stent valve prosthesis were included in this descriptive study and compared with a historical control group of 21 patients undergoing open surgical aortic valve replacement. Periprocedural apparent and silent cerebral ischemia was assessed by neurological testing and serial cerebral diffusion-weighted magnetic resonance imaging at baseline, at 3.4 (2.5 to 4.4) days after the procedure, and at 3 months. TAVI was successful in all patients. After the procedure, new foci of restricted diffusion on cerebral diffusion-weighted magnetic resonance imaging were found in 27 of 32 TAVI patients (84%)

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Section: Preoperative Assessment Of Potential Sources Of Embolismmentioning

confidence: 99%

Silent and Apparent Cerebral Ischemia After Percutaneous Transfemoral Aortic Valve Implantation

Kahlert

Knipp²,

Schlamann³

et al. 2010

Circulation

477

297

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“…Stenoses of the common, internal, and external carotid arteries were measured as reduced diameter and were graded with consideration of all information from B-mode, pulsed-wave, and color flow Doppler. 19 Carotid stenoses were considered significant if there was Ͼ70% diameter reduction.…”

Section: Preoperative Assessment Of Potential Sources Of Embolismmentioning

confidence: 99%

Cerebral Embolization During Transcatheter Aortic Valve Implantation

et al. 2012

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Background-Transcatheter aortic valve implantation (TAVI) is associated with a higher risk of neurological events for both the transfemoral and transapical approach than surgical valve replacement. Cerebral magnetic resonance imaging has revealed more new, albeit clinically silent lesions from procedural embolization, yet the main source and predominant procedural step of emboli remain unclear. 001).Overall, there were no significant differences between transfemoral and transapical TAVI or between the MCV and ES prostheses. No HITS were detected at baseline or 3-month follow-up. There was 1 major procedural stroke that resulted in death and 1 minor procedural stroke with full recovery at 3-month follow-up in the MCV group. Conclusions-Procedural HITS were detected by transcranial Doppler in all patients. Although no difference was observed between the transfemoral and the transapical approach with the balloon-expandable ES stent valve, transfemoral TAVI with the self-expandable MCV prosthesis resulted in the greatest number of HITS, predominantly during implantation. (Circulation. 2012;126:1245-1255.)

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“…32 Other authors reported an overall sensitivity of 91% to 95% and specificity of 86% to 97%. 1 Color and duplex Doppler sonography and DSA have shown agreement in at least 90% of the cases in the grading of stenosis. 45,46 The complication rate for DSA is 1% to 2% for both stroke and death.…”

Section: Comparison Of the Diagnostic Value Of Color Duplex Sonographmentioning

confidence: 95%

“…Four of 5 of the ischemic events are caused by atherosclerotic diseases, with most changes affecting the carotid bifurcation. 1 Two randomized studies, the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST), were performed in symptomatic patients to examine the efficacy of carotid endarterectomy (CEA) in patients with highgrade (≥70%) internal carotid artery (ICA) stenosis based on the angiographic estimation of the degree of stenosis. It was proved that these patients did benefit from carotid surgery compared with the group receiving conservative treatment.…”

mentioning

confidence: 99%

Diagnosing Carotid Stenosis by Doppler Sonography

Gaitini

Soudack

2005

Journal of Ultrasound in Medicine

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Objective. The goal of this review article is to present the state of the art in the clinical applications and technical performance and interpretation of carotid sonographic examinations. Methods. Relevant publications regarding color and duplex Doppler sonography (CDDS) of the carotid arteries extracted from a computerized database (MEDLINE) and from references cited in these articles not appearing on the Internet were reviewed. Results. The ability to quickly and efficiently identify stenosis in the carotid artery is an important goal for clinicians and vascular surgeons. Identification of potentially treatable carotid stenosis enables selection of appropriate candidates for endarterectomy or stent implantation. Advances in performance and interpretation of carotid sonographic studies over the last 20 years have been driven by technological improvements in gray scale and CDDS examinations and have made carotid sonography an important means to reach this goal. On the basis of CDDS, intimamedia thickness measurements and plaque location and characterization on gray scale imaging, flow disturbance and areas of stenosis on color Doppler sonography, and flow velocities on spectral Doppler sonography are obtained. The degree of the diameter of a stenosis of the internal carotid artery is the main parameter used for therapeutic approaches. Advantages and limitations of the method are included. Conclusions. Carotid sonography is a unique imaging method for the investigation of carotid abnormalities. Noninvasive, accurate, and cost-effective, it provides morphologic and functional information. It is increasingly becoming the first and often the sole imaging study before endarterectomy, whereas costly and invasive procedures are reserved for special cases.

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Ultrasound examination of carotid and vertebral arteries

Cited by 57 publications

References 51 publications

Silent and Apparent Cerebral Ischemia After Percutaneous Transfemoral Aortic Valve Implantation

Silent and Apparent Cerebral Ischemia After Percutaneous Transfemoral Aortic Valve Implantation

Cerebral Embolization During Transcatheter Aortic Valve Implantation

Diagnosing Carotid Stenosis by Doppler Sonography

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