Yield and accuracy of urgent combined carotid/transcranial ultrasound testing in acute cerebral ischemia

We routinely perform an urgent bedside neurovascular ultrasound examination (NVUE) with carotid/vertebral duplex and transcranial Doppler (TCD) in patients with acute cerebral ischemia. We aimed to determine the yield and accuracy of NVUE to identify lesions amenable for interventional treatment (LA...

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Bibliographic Details
Published in:Stroke (1970) 2005, Vol.36 (1), p.32-37
Main Authors: CHERNYSHEV, Oleg Y, GARAMI, Zsolt, ALEXANDROV, Andrei V, CALLEJA, Sergio, SONG, Joon, CAMPBELL, Morgan S, NOSER, Elizabeth A, SHALTONI, Hashem, CHEN, Chin-I, IGUCHI, Yasuyuki, GROTTA, James C
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Angiography, Digital Subtraction
Biological and medical sciences
Brain Ischemia - diagnostic imaging
Carotid Arteries - diagnostic imaging
Carotid Stenosis - diagnostic imaging
Female
Humans
Intracranial Arterial Diseases - diagnostic imaging
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Nervous system
Neurology
Neurosurgery
Point-of-Care Systems
Reproducibility of Results
Skull, brain, vascular surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Ultrasonic investigative techniques
Ultrasonography, Doppler, Duplex
Ultrasonography, Doppler, Transcranial
Vascular diseases and vascular malformations of the nervous system
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Summary:We routinely perform an urgent bedside neurovascular ultrasound examination (NVUE) with carotid/vertebral duplex and transcranial Doppler (TCD) in patients with acute cerebral ischemia. We aimed to determine the yield and accuracy of NVUE to identify lesions amenable for interventional treatment (LAITs). NVUE was performed with portable carotid duplex and TCD using standardized fast-track ( or =50% stenoses or thrombus in the symptomatic artery. One hundred and fifty patients (70 women, mean age 66+/-15 years) underwent NVUE at median 128 minutes after symptom onset. Fifty-four patients (36%) received intravenous or intra-arterial thrombolysis (median National Institutes of Health Stroke Scale (NIHSS) score 14, range 4 to 29; 81% had NIHSS > or =10 points). NVUE demonstrated LAITs in 98% of patients eligible for thrombolysis, 76% of acute stroke patients ineligible for thrombolysis (n=63), and 42% in patients with transient ischemic attack (n=33), P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.0000150496.27584.e3