Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation

Shigeki Morita, Masahiro Yasaka, Kotaro Yasumori, Yasuhisa Oishi, Toru Takaseya, Hiromichi Sonoda, Takemi Kawara

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The assessment of intracranial arterial communication is important to prevent a stroke from occurring during an aortic arch operation. Bilateral axillary artery perfusion was used with the left common carotid artery perfusion for selective cerebral perfusion. A preoperative left carotid artery compression test with measurement of the left middle cerebral artery (LMCA) flow was performed to determine how safe it was to interrupt the perfusion to the left common carotid artery. Methods: Eighteen patients who were scheduled for an aortic arch operation underwent the test. Before surgery, the LMCA flow was detected using transcranial Doppler ultrasonography. During manual compression of the left carotid artery, the flow velocity of the LMCA was measured and expressed as a percent in comparison to the precompression value. Results: During carotid artery compression, flow velocity of the LMCA was reduced to 56% ± 36% (median, 63%; range, 0% to 100%) of the precompression value. The communication to the LMCA assessed with magnetic resonance angiography showed a weak relationship to the functional flow reserve of the LMCA based on a transcranial Doppler study. The results indicated that morphologic observation with magnetic resonance angiography did not reflect the dynamic nature of the intracranial collaterals. Conclusions: A preoperative left carotid artery compression test with a measurement of the flow of the LMCA is useful to assess the feasibility of interrupting perfusion to the left carotid artery during aortic arch surgery with bilateral axillary artery perfusion.

Original languageEnglish
Pages (from-to)448-451
Number of pages4
JournalAnnals of Thoracic Surgery
Volume86
Issue number2
DOIs
Publication statusPublished - Aug 1 2008
Externally publishedYes

Fingerprint

Middle Cerebral Artery
Thoracic Aorta
Communication
Carotid Arteries
Perfusion
Axillary Artery
Magnetic Resonance Angiography
Common Carotid Artery
Doppler Transcranial Ultrasonography
Stroke
Observation

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation. / Morita, Shigeki; Yasaka, Masahiro; Yasumori, Kotaro; Oishi, Yasuhisa; Takaseya, Toru; Sonoda, Hiromichi; Kawara, Takemi.

In: Annals of Thoracic Surgery, Vol. 86, No. 2, 01.08.2008, p. 448-451.

Research output: Contribution to journalArticle

Morita, Shigeki ; Yasaka, Masahiro ; Yasumori, Kotaro ; Oishi, Yasuhisa ; Takaseya, Toru ; Sonoda, Hiromichi ; Kawara, Takemi. / Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation. In: Annals of Thoracic Surgery. 2008 ; Vol. 86, No. 2. pp. 448-451.
@article{236d926f71e445fd867f96df92f0ec6c,
title = "Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation",
abstract = "Background: The assessment of intracranial arterial communication is important to prevent a stroke from occurring during an aortic arch operation. Bilateral axillary artery perfusion was used with the left common carotid artery perfusion for selective cerebral perfusion. A preoperative left carotid artery compression test with measurement of the left middle cerebral artery (LMCA) flow was performed to determine how safe it was to interrupt the perfusion to the left common carotid artery. Methods: Eighteen patients who were scheduled for an aortic arch operation underwent the test. Before surgery, the LMCA flow was detected using transcranial Doppler ultrasonography. During manual compression of the left carotid artery, the flow velocity of the LMCA was measured and expressed as a percent in comparison to the precompression value. Results: During carotid artery compression, flow velocity of the LMCA was reduced to 56{\%} ± 36{\%} (median, 63{\%}; range, 0{\%} to 100{\%}) of the precompression value. The communication to the LMCA assessed with magnetic resonance angiography showed a weak relationship to the functional flow reserve of the LMCA based on a transcranial Doppler study. The results indicated that morphologic observation with magnetic resonance angiography did not reflect the dynamic nature of the intracranial collaterals. Conclusions: A preoperative left carotid artery compression test with a measurement of the flow of the LMCA is useful to assess the feasibility of interrupting perfusion to the left carotid artery during aortic arch surgery with bilateral axillary artery perfusion.",
author = "Shigeki Morita and Masahiro Yasaka and Kotaro Yasumori and Yasuhisa Oishi and Toru Takaseya and Hiromichi Sonoda and Takemi Kawara",
year = "2008",
month = "8",
day = "1",
doi = "10.1016/j.athoracsur.2008.04.024",
language = "English",
volume = "86",
pages = "448--451",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation

AU - Morita, Shigeki

AU - Yasaka, Masahiro

AU - Yasumori, Kotaro

AU - Oishi, Yasuhisa

AU - Takaseya, Toru

AU - Sonoda, Hiromichi

AU - Kawara, Takemi

PY - 2008/8/1

Y1 - 2008/8/1

N2 - Background: The assessment of intracranial arterial communication is important to prevent a stroke from occurring during an aortic arch operation. Bilateral axillary artery perfusion was used with the left common carotid artery perfusion for selective cerebral perfusion. A preoperative left carotid artery compression test with measurement of the left middle cerebral artery (LMCA) flow was performed to determine how safe it was to interrupt the perfusion to the left common carotid artery. Methods: Eighteen patients who were scheduled for an aortic arch operation underwent the test. Before surgery, the LMCA flow was detected using transcranial Doppler ultrasonography. During manual compression of the left carotid artery, the flow velocity of the LMCA was measured and expressed as a percent in comparison to the precompression value. Results: During carotid artery compression, flow velocity of the LMCA was reduced to 56% ± 36% (median, 63%; range, 0% to 100%) of the precompression value. The communication to the LMCA assessed with magnetic resonance angiography showed a weak relationship to the functional flow reserve of the LMCA based on a transcranial Doppler study. The results indicated that morphologic observation with magnetic resonance angiography did not reflect the dynamic nature of the intracranial collaterals. Conclusions: A preoperative left carotid artery compression test with a measurement of the flow of the LMCA is useful to assess the feasibility of interrupting perfusion to the left carotid artery during aortic arch surgery with bilateral axillary artery perfusion.

AB - Background: The assessment of intracranial arterial communication is important to prevent a stroke from occurring during an aortic arch operation. Bilateral axillary artery perfusion was used with the left common carotid artery perfusion for selective cerebral perfusion. A preoperative left carotid artery compression test with measurement of the left middle cerebral artery (LMCA) flow was performed to determine how safe it was to interrupt the perfusion to the left common carotid artery. Methods: Eighteen patients who were scheduled for an aortic arch operation underwent the test. Before surgery, the LMCA flow was detected using transcranial Doppler ultrasonography. During manual compression of the left carotid artery, the flow velocity of the LMCA was measured and expressed as a percent in comparison to the precompression value. Results: During carotid artery compression, flow velocity of the LMCA was reduced to 56% ± 36% (median, 63%; range, 0% to 100%) of the precompression value. The communication to the LMCA assessed with magnetic resonance angiography showed a weak relationship to the functional flow reserve of the LMCA based on a transcranial Doppler study. The results indicated that morphologic observation with magnetic resonance angiography did not reflect the dynamic nature of the intracranial collaterals. Conclusions: A preoperative left carotid artery compression test with a measurement of the flow of the LMCA is useful to assess the feasibility of interrupting perfusion to the left carotid artery during aortic arch surgery with bilateral axillary artery perfusion.

UR - http://www.scopus.com/inward/record.url?scp=47149084585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47149084585&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2008.04.024

DO - 10.1016/j.athoracsur.2008.04.024

M3 - Article

C2 - 18640313

AN - SCOPUS:47149084585

VL - 86

SP - 448

EP - 451

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 2

ER -