Authors: Sorrell K.; Harris S.; Carpenter J.; Lugo A.; Wills S.; Tuvell N.

Source: Journal for Vascular Ultrasound, Volume 27, Number 4, 1 December 2003 , pp. 211-218(8)

Publisher: Society for Vascular Ultrasound

Abstract:

Introduction.—Recent advances in neuroradiology have made it possible to perform superselective catheterization of the intracranial arteries. Intra-arterial papaverine infusion (PI) or percutaneous transluminal balloon angioplasty (PTA) can then be performed to treat vasospasm after subarachnoid hemorrhage (SAH). The purpose of this study was to determine the correlation between the angiographic result and transcranial color duplex ultrasound (TCDU) and to define a velocity threshold that could be used to predict the success of endovascular treatment for vasospasm.

Methods.—Seven patients with SAH and symptomatic cerebral vasospasm underwent endovascular therapy and daily TCDU. PTA and/or PI was performed on a total of 23 arterial segments. Fifteen arterial segments were treated once, and eight segments required a second or third intervention. Preintervention and postintervention TCDU velocities were compared with angiographic results.

Results.—Good to excellent relief of spasm was reported in 15 segments on the basis of postintervention angiography. The average preintervention TCDU velocity for these 15 responders was 170 cm/sec. Velocities dropped to an average of 96.5 cm/sec immediately after intervention. For the eight nonresponders, the average velocity pretreatment was 128 cm/sec. Angiography demonstrated modest or no relief of spasm after PTA or PI, and the average velocity after treatment was 130 cm/sec. When a change of >25 cm/sec was used, TCDU correctly predicted angiographic responders with a p value of < 0.01.

Conclusions.—Our data demonstrate a strong correlation between the angiographic result and the drop in velocity after endovascular therapy for vasospasm. Postintervention TCDU values can be used as a point of reference from which to monitor further progression or regression of vasospasm. We believe that TCDU has significant value in the management decisions of endovascular interventions for the treatment of cerebral vasospasm.

Document Type: Research article

Publication date: 2003-12-01

More about this publication?

• The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.
  
  Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
• Editorial Board
• Information for Authors
• Subscribe to this Title
• Membership Information
• Information for Advertisers
• Reprints
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Radiology & Imaging ,  Acoustics
• By this author: Sorrell K. ;  Harris S. ;  Carpenter J. ;  Lugo A. ;  Wills S. ;  Tuvell N.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers