Ultrasonically assisted evaluation of the impact of atherosclerotic plaque on the pulse pressure wave propagation: a clinical feasibility study.

The purpose of this work was to evaluate ultrasound modality as a non-invasive tool for determination of impact of the degree of the atherosclerotic plaque located in human internal carotid arteries on the values of the parameters of the pulse wave. Specifically, the applicability of the method to such arteries as brachial, common, and internal carotid was examined. The method developed is based on analysis of two characteristic parameters: the value of the mean reflection coefficient modulus |Γ|(a) of the blood pressure wave and time delay Δt between the forward (travelling) and backward (reflected) blood pressure waves. The blood pressure wave was determined from ultrasound measurements of the artery's inner (internal) diameter, using the custom made wall tracking system (WTS) operating at 6.75 MHz. Clinical data were obtained from the carotid arteries measurements of 70 human subjects. These included the control group of 30 healthy individuals along with the patients diagnosed with the stenosis of the internal carotid artery (ICA) ranging from 20% to 99% or with the ICA occlusion. The results indicate that with increasing level of stenosis of the ICA the value of the mean reflection coefficient measured in the common carotid artery, significantly increases from |Γ|(a)=0.45 for healthy individuals to |Γ|(a)=0.61 for patients with stenosis level of 90-99%, or ICA occlusion. Similarly, the time delay Δt decreases from 52 ms to 25 ms for the respective groups. The method described holds promise that it might be clinically useful as a non-invasive tool for localization of distal severe artery narrowing, which can assist in identifying early stages of atherosclerosis especially in regions, which are inaccessible for the ultrasound probe (e.g. carotid sinus or middle cerebral artery).

[Ultrasonic noninvasive examination of the human cerebrovascular system using the vascular impedance method]. / Ultradzwiekowa nieinwazyjna diagnostyka ukladu naczyniowo-mózgowego czlowieka, metoda wejsciowej impedancji naczyniowej.

The authors employed input vascular impedance measurements, based on the non-invasive ultrasound measurements of blood flow and pressure in common carotid artery, to evaluate human cerebro-vascular system. An analysis involved a 4-element substitute model of vascular system which included: compliance, inertia, vascular resistance, and peripheral resistance. Preliminary clinical examination of both sick and healthy individuals indicate that total real resistance measured in the common carotid artery depends on the patency of branching arteries. At the same time, ratio of vascular resistance Ro do peripheral resistance Rp may be an indicator of the atheromatous lesions to the arteries below measurement point. Ratio Ro greater than 0.5 is being considered as an index of pathology.