Role of transcranial Doppler ultrasonography in assessing stenosis after flow diversion

医学 狭窄 经颅多普勒 数字减影血管造影 颈内动脉 放射科 支架 心脏病学 血管造影 内科学
作者
Damian Kocur,Piotr Paździora,Jan Baron,Adam Rudnik
出处
期刊:Clinical Neurology and Neurosurgery [Elsevier BV]
卷期号:198: 106219-106219 被引量:3
标识
DOI:10.1016/j.clineuro.2020.106219
摘要

Abstract Introduction Patients after implantation of flow diverters (FD) due to intracranial aneurysms require radiological and clinical follow-up in view of in-stent stenosis. The aim of the study was to evaluate transcranial Doppler ultrasonography (TCD) as an alternative to more invasive digital subtraction angiography in monitoring patients with FD. Patients and methods Twenty-five patients after FD deployment due to internal carotid artery (ICA) aneurysms were reviewed. The degree stenosis found on TCD was compared with the results of catheter angiography. The TCD examinations were recorded from two sides at the extracranial ICA and the most proximal and distal segment of intracranial ICA. Analyzed TCD factors included: peak systolic blood flow velocity, end diastolic velocity, mean velocity, pulsatility index, and resistivity index. The side-to-side differences and ratios between particular TCD indices were calculated. Results The cumulative frequency of angiographic in-stent stenosis was 5 of 25 (20 %). The analysis showed that pulsatility index measured on the most proximal intracranial segment of ICA is a predictor for angiographic instent stenosis (AUC = 0.854; p = 0.04; 95 % CI 0.59–1.00). The threshold of pulsatility index separating stenosis and non-stenosis groups was 1.05 with a sensitivity of 50 % and a specificity of 100 %. As the cut-off threshold of PI was set 0.75 the sensitivity and specificity was 100 % and 16.7 %, respectively. Conclusions The increased TCD-derived pulsatility index measured on the most proximal intracranial segment of ICA is associated with in-stent stenosis demonstrated on angiograms.
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