Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Показатели гемодинамики при стенозе в устье позвоночных артерий по данным дуплексного сканирования

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Link: Clinical Physiology of Blood Circulaiton. 2011; (): -

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Abstract

Objective of the work is to compare motor subtraction angiography with the results of duplex scanning to determine optimal threshold parameters of hemodynamics in the diagnosis of stenosis at the ostium the vertebral arteries. Small number of works devoted to this problem and high risk of repeated disorder of cerebral circulation at the vertebral basilar system makes topical the problem of timely and accurate diagnosis of vertebral arteries patency. Material and methods. The study included 42 patients (34 males and 8 females) at the age of 49-79 years, in whom the image of 53 vertebral arteries with stenosis <50%, 50-69 and 70-99% was obtained with selective angiography. Ultrasound study included the following blood flow values: systolic blood flow speed (Vs) at the ostium, (Vs) at the segment V2 and ratio Vs at the ostium versus Vs at the segment V2. Results. Up to 59% Vs at the ostium and the ratio of systolic velocities were not more than 80 cm/s and 2.2 respectively. For stenosis of vertebral arteries at the ostium 70% and more optimal threshold hemodynamic values were: Vs at the ostium 160 cm/s and more (sensitivity 92%, specificity 65%), ratio ostium Vs versus Vs at the vertebral canal was 4.5 (sensitivity 91%, specificity 88%). The most informative values were Vs at the ostium and velocity ratio which had no statistically significant differences with each other (p=0.67). Conclusion. Blood flow velocity threshold values obtained can be used as referential in the assessment of vertebral arteries patency with duplex scanning. Accurate and timely diagnosis of hemodynamically significant stenoses of vertebral arteries will help to select therapeutic approach for the treatment of patients

References

Верещагин, Н. В. Патология вертебрально-базилярной системы и нарушения мозгового кровообращения / Н. В. Верещагин. - М.: Медицина, 1980.
Кротенкова, М. В. Современные методы нейровизуализации в ангионеврологии / М. В. Кротенкова, Р. Н. Коновалов, Л. А. Калашникова; под ред. З. А. Суслиной // Очерки ангионеврологии. - М.: Атмосфера, 2005. - C. 142-161.
Ackerstaff, R. Ultrasonic duplex scanning of the prevertebral segment of the vertebral artery in patients with cerebral atherosclerosis / R. Ackerstaff, W. Grosveld, B. Eikelboom et al. // Eur. J. Vasc. Surg. - 1988. - Vol. 2, № 6. - P. 387-393.
Bamford, J. Classification and natural history of clinically identifiable subtypes of cerebral infarction / J. Bamford, P. Sandercock, M. Dennis et al. // Lancet. - 1991. - Vol. 337, № 8756. - P. 1521-1526.
Bogousslavsky, J. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke / J. Bogousslavsky, G. Van Melle, F. Regli // Stroke. - 1988. - Vol. 19, № 9. - P. 1083-1092.
Cloud, G. Diagnosis and management of vertebral artery stenosis / G. Cloud, H. Markus // QJM. - 2003. -Vol. 96, № 1. - P. 27-34.
De Bray, J. Accuracy of color-Doppler in the quantification of proximal vertebral artery stenoses / J. De Bray, A. Pasco, F. Tranquart et al. // Cerebrovasc. Dis. - 2001. - Vol. 11, № 4. - P. 335-340.
Hua, Y. Color Doppler imaging evaluation of proximal vertebral artery stenosis / Y. Hua, X. Meng, L. Jia et al. // Am. J. Roentgenol. - 2009. - Vol. 193, № 5. - P. 1434-1438.
Khan, S. Imaging of vertebral artery stenosis: a systematic review / S. Khan, G. Cloud, S. Kerry et al. // J. Neurol. Neurosurg. Psychiatry. - 2007. - Vol. 78, № 11. - P. 1218-1225.
Koch, S. Ultrasound velocity criteria for vertebral origin stenosis / S. Koch, J. Romano, H. Park et al. // J. Neuroimaging. - 2009. - Vol. 19, № 3. - P. 242-245.
North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress // Stroke. - 1991. - Vol. 22. - P. 711-720.
Visona, A. The echo-Doppler (duplex) system for the detection of vertebral artery occlusive disease: comparison with angiography / A. Visona, L. Lusiani, V. Castellani et al. // J. Ultrasound. Med. - 1986. - Vol. 5, № 5. - P. 247-250.
Wehman, J. Atherosclerotic occlusive extracranial vertebral artery disease: indications for intervention, endovascular techniques, short-term and long-term results / J. Wehman, R. Hanel, C. Guidot et al. // J. Interv. Cardiol. - 2004. - Vol. 17, № 4. - P. 219-232.
Wityk, R. Proximal extracranial vertebral artery disease in the New England Medical Center Posterior Circulation Registry / R. Wityk, H. Chang, A. Rosengart et al. // Arch. Neurol. - 1998. - Vol. 55, № 4. - P. 470-478.
Yurdakul, M. Doppler criteria for identifying proximal vertebral artery stenosis of 50% or more / M. Yurdakul, M. Tola // J. Ultrasound. Med. - 2011. - Vol. 30, № 2. - P. 163-168.

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