Intracranial Blood Flow Velocity in Patients withβ-Thalassemia Intermedia Using Transcranial Doppler Sonography: A Case-Control Study

Nahid Ashjazadeh,Sajad Emami,Peyman Petramfar,Ehsan Yaghoubi,Mehran Karimi

doi:10.1155/2012/798296

Abstract

Introduction. Patients with β-thalassemia intermedia have a higher incidence of thromboembolic events compared to the general population. Previous studies have shown that patients with sickle cell disease, who are also prone to ischemic events, have higher intracranial arterial blood flow velocities measured by transcranial Doppler sonography (TCD). The aim of this study is to evaluate intracranial arterial flow velocities in patients with β-thalassemia intermedia and compare the results with those found in healthy subjects. Methods. Sixty-four patients with β-thalassemia intermedia and 30 healthy subjects underwent transcranial Doppler sonography. Results. Significantly higher flow velocities were found in intracranial arteries of patients compared to controls (P = 0.001). Previously splenectomized patients with thrombocytosis showed higher flow velocities than nonsplenectomized patients without thrombosis. Conclusion. The increased flow velocities in patients with β-thalassemia intermedia may point to a higher risk of ischemic events. Preventive measures such as blood transfusion or antiplatelet treatment may be beneficial in these patients.

Highlights

Patients with β-thalassemia intermedia have a higher incidence of thromboembolic events compared to the general population
transcranial Doppler sonography (TCD) measurement of intracranial flow velocities is of aid in deciding when to start blood transfusion in these patients to reduce the risk of ischemic stroke [8, 9]
Flow velocity was higher in most arteries of splenectomized patients compared to nonsplenectomized patients, especially in the anterior circulation

Summary

Introduction

Patients with β-thalassemia intermedia have a higher incidence of thromboembolic events compared to the general population. Previous studies have shown that patients with sickle cell disease, who are prone to ischemic events, have higher intracranial arterial blood flow velocities measured by transcranial Doppler sonography (TCD). Previous splenectomy and thrombocytosis and/or platelet abnormalities are major factors associated with thromboembolic events in patients with β-thalassemia intermedia [1, 3, 4], and ischemic stroke is increasingly recognized as one of the most devastating complications of this disease [5]. The stroke prevention trial in sickle cell anemia (STOP) has indicated a role for transcranial Doppler sonography (TCD) in measuring intracranial arterial flow velocities to identify sickle cell patients at a high risk of ischemic stroke [8]. TCD measurement of intracranial flow velocities is of aid in deciding when to start blood transfusion in these patients to reduce the risk of ischemic stroke [8, 9]

Objectives

Methods

Conclusion