Noninvasive assessment of STA-MCA anastomosis using ultrasonic Doppler flowmetry
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概要
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Ultrasonic Doppler sonography has been applied to evaluate the patency of superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis. This study included 13 patients with internal carotid artery occlusion or stenosis who had undergone STA-MCA anastomosis. The blood flow patterns of the STA, ophthalmic and major aortocranial arteries in all patients were analysed by Doppler sonography. Futhermore, long-term follow-up studies were also performed in ten cases.<BR>In patients with good patency demonstrated by postoperative angiograms, the flow pattern of STA showed increase in systolic and diastolic velocities and changed to an internal carotid type from an external carotid type. The findings of Doppler sonograms of STA were well consistent with the postoperative angiograms and precisely represented the bypass patency. In long-term follow-up cases, the alterations of STA flow on the sonograms were concurrent with those of the blood flow distribution via anastomosis on the second postoperative angiograms. In ten cases with reverse flow direction in ophthalmic arteries before the operation, the reverse flow decreased in eight cases postoperatively. But no significant changes of the reversed ophthalmic flows were detected in the remaining two cases. The flow direction of ophthalmic artery was vulnerable to the pressure change, especially, in the case with internal carotid occlusion and easily affected by infusion pressure of the contrast material. Therefore, Doppler flowmetry is suitable for detecting the change of the ophthalmic flow in the physiological condition. The blood flow velocity patterns of major aortocranial arteries showed no change postoperatively.<BR>In conclusion, it was proved that the detection of the STA and the other collateral flow using the ultrasonic Doppler sonography was an excellent and reliable means for assessment and monitoring of bypass patency.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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