Evaluation Of Extracranial Carotid Disease Research Articles

DETECTION OF CAROTID OCCLUSIVE DISEASE BY PULSED DOPPLER SPECTRAL ANALYSIS

In this study a new pulsed Doppler spectral analysis system was used for the evaluation of extracranial carotid disease. When compared to the arteriography findings in 224 carotid arteries, the Doppler examination correctly detected all stenoses greater than 25%, all occlusions, all normal vessels, and 43% of stenosis causing a diameter reduction of less than 25%.

Sensitivity of hemodynamic parameters determined with a conventional duplex scanner in the evaluation of severe extracranial carotid disease

Progression of extracranial carotid disease is considered to be significant independent predictor in the evaluation of individual cerebrovascular prognosis. Doppler ultrasonography is a useful screening method in the diagnosis and evaluation of extracranial carotid disease. The aim of this study was to establish the most sensitive hemodynamic parameter of Doppler-ultrasonographic spectral analysis in clinical evaluation of extracranial carotid disease. Investigation included 90 patients (of both sexes) in hospital and outpatient clinic care. Spectral analysis (M-scanning technique) was used for the evaluation of hemodynamic status of carotid sinus, including the following parameters: Pourcelot (A-D/A), Gosling (A/B), and Mol (A/D) resistance parameters. After statistical processing the results of the research affirmed hemodynamic parameters' values and correlation between Pourcelot hemodynamic parameter and the degree of carotid stenosis rho = 0.59 for all patients, and rho = 0.58 for patients with pathological values. Correlation between Mol parameter and the degree of carotid stenosis was rho = 0.50 for all patients, and rho = 0.57 for patients with pathological values. Gosling parameter was not significantly different in mean value and was present in all three groups. Functional relationship between the degree of carotid stenosis and each of hemodynamic parameters was established. It was concluded that Pourcelot and Mol parameters were significant indicators of asimptomatic carotid disease, but Pourcelot parameter was considered as a more sensitive indicator in the evaluation of extracranial carotid disease.

Correlation of transcranial Doppler and noninvasive tests with angiography in the evaluation of extracranial carotid disease

To evaluate the usefulness of transcranial Doppler sonography in determining severity of extracranial carotid disease, we compared transcranial Doppler, ocular pneumoplethysmography, Doppler spectral analysis, and duplex scanning data to information derived from cerebral angiography. Fifty-one consecutive patients with unilateral extracranial internal carotid artery stenosis or occlusion were selected. Transcranial Doppler indexes included the peak systolic flow velocity in the middle cerebral artery ipsilateral to the stenosed internal carotid artery (iMCAFV), the difference between the peak systolic flow velocities in the middle cerebral artery ipsilateral and contralateral to the stenosed internal carotid artery (dMCAFV), and the peak systolic flow velocity in the anterior cerebral artery contralateral to the stenosed internal carotid artery (cACAFV). The minimal residual lumen determined angiographically was used as the index of internal carotid artery stenosis. Linear regression analysis with minimal residual lumen as the dependent variable and transcranial Doppler and noninvasive tests as independent variables showed the following correlation coefficients: (1) dMCAFV and cACAFV, R2 = 0.3170; (2) ocular pneumoplethysmography, R2 = 0.4798; (3) dMCAFV, cACAFV, delta ocular pneumoplethysmography, duplex scanning, and spectral analysis R2 = 0.6382; (4) ocular pneumoplethysmography, duplex scanning, and spectral analysis, R2 = 0.6491; (5) iMCAFV, no association. These results were supported by sensitivity and specificity as well as bivariate analysis. We conclude that transcranial Doppler did not significantly add to the information obtained by our noninvasive battery of tests in the evaluation of unilateral extracranial carotid disease.

Correlation of transcranial Doppler and noninvasive tests with angiography in the evaluation of extracranial carotid disease

To evaluate the usefulness of transcranial Doppler sonography in determining severity of extracranial carotid disease, we compared transcranial Doppler, ocular pneumoplethysmography, Doppler spectral analysis, and duplex scanning data to information derived from cerebral angiography. Fifty-one consecutive patients with unilateral extracranial internal carotid artery stenosis or occlusion were selected. Transcranial Doppler indexes included the peak systolic flow velocity in the middle cerebral artery ipsilateral to the stenosed internal carotid artery (iMCAFV), the difference between the peak systolic flow velocities in the middle cerebral artery ipsilateral and contralateral to the stenosed internal carotid artery (dMCAFV), and the peak systolic flow velocity in the anterior cerebral artery contralateral to the stenosed internal carotid artery (cACAFV). The minimal residual lumen determined angiographically was used as the index of internal carotid artery stenosis. Linear regression analysis with minimal residual lumen as the dependent variable and transcranial Doppler and noninvasive tests as independent variables showed the following correlation coefficients: (1) dMCAFV and cACAFV, R2 = 0.3170; (2) ocular pneumoplethysmography, R2 = 0.4798; (3) dMCAFV, cACAFV, Δ ocular pneumoplethysmography, duplex scanning, and spectral analysis R2 = 0.6382; (4) ocular pneumoplethysmography, duplex scanning, and spectral analysis, R2 = 0.6491; (5) iMCAFV, no association. These results were supported by sensitivity and specificity as well as bivariate analysis. We conclude that transcranial Doppler did not significantly add to the information obtained by our noninvasive battery of tests in the evaluation of unilateral extracranial carotid disease.

Detection of carotid occlusive disease by pulsed Doppler spectral analysis.

In this study a new pulsed Doppler spectral analysis system was used for the evaluation of extracranial carotid disease. When compared to the arteriography findings in 224 carotid arteries, the Doppler examination correctly detected all stenoses greater than 25%, all occlusions, all normal vessels, and 43% of stenosis causing a diameter reduction of less than 25%.