Three-dimensional hemodynamic study of carotid bulb in patients with evolving stroke

Abstract

Objectives Determining carotid stenosis severity, monitoring of carotid plaque, and identification of vulnerable plaques are important in identifying patients who would benefit from carotid endarterectomy (CEA). Our work aimed to evaluate the role of three-dimensional (3D) hemodynamic study in patient with evolving stroke. Patients and methods The study enrolled 20 patients diagnosed with forebrain stroke selected from our university hospital from March 2017 to February 2019. The severity of stenosis and the length and type of plaques were quantified by 3D ultrasound (US). Overall, 17 patients underwent CEA. The follow-up after operation was done by 3D US with measuring the free lumen area and the operated artery. Results There are significant increases in postoperative peak systolic velocity and free lumen area in all patients with stenosis or occlusion, with P value 0.001 and 0.0001, respectively, in most critical cases of the soft plaques. Moreover, there is a higher significant P value (0.003) regarding peak systolic velocity related to carotid end-arterectomy (CEA) with patching than nonpatching. Conclusion 3D US imaging is a recent tool for improving the visualization and quantification of complex anatomy and pathology as well as monitoring progression of atherosclerosis.