Transcranial color Doppler ultrasonography for the assessment of anterior communicating artery ;patency in patients with severe carotid artery stenosis / 中国脑血管病杂志

ABSTRACT

Objective To investigate the evaluation value of anterior communicating artery patency for patients with severe carotid artery stenosis treated by carotid endarterectomy (CEA )with transcranial color Doppler ultrasonography. Methods From June 2014 to June 2015,89 consecutive inpatients with unilateral symptomatic severe carotid stenosis treated with CEA at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. They were divided into either a patent group (n=45)or a non-patent group (n=44)according to whether the anterior communicating artery was patent or not (DSA findings). Whether the anterior communicating artery was patent or not diagnosed by the transcranial color Doppler ultrasonography was compared with the consistency of the digital subtraction angiography (DSA)results. The differences of intraoperatively implemented temporary shunt rate and the differences of hemodynamic parameters including peak velocity (PSV),end-diastolic velocity (EDV),and pulsatility index (PI)of the preoperative and postoperative bilateral middle cerebral artery and anterior cerebral artery (ACA)of both groups were analyzed. Results Compared with the results of DSA, the sensitivity and specificity of transcranial color Doppler ultrasonography for preoperative evaluation of the patency of anterior communicating artery were 91. 1%(41/45)and 97. 7%(43/44)respectively,the total accordance rate was 94. 4%(84/89)(Kappa=0. 888,P0.05). There were no significant differences in PSV,EDV and PI of the contralateral ACA in the non-patent group between after procedure and before procedure (all P>0. 05). Conclusions Transcranial color Doppler ultrasonography can accurately and objectively evaluate whether the anterior communicating artery is patent or not in patients with unilateral severe carotid stenosis. It has an important clinical significance for selective shunt in CEA and improving the success rate of CEA.