The use of direct intra-operative Doppler ultrasonography in carotid thromboendarteriectomy. A prospective study
Autor: | R. Stendel, Mario Brock, T. Hupp, A. Abo Al Hassan |
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Rok vydání: | 1998 |
Předmět: |
Male
medicine.medical_specialty Ultrasonography Doppler Transcranial Asymptomatic Sensitivity and Specificity Monitoring Intraoperative medicine Humans Carotid Stenosis Ultrasonography Doppler Color Prospective cohort study Intraoperative Complications Neuroradiology Aged Aged 80 and over Endarterectomy Carotid medicine.diagnostic_test Vascular disease business.industry Vasospasm Interventional radiology Equipment Design Middle Aged medicine.disease Surgery Cerebral Angiography Stenosis Ischemic Attack Transient Angiography Female Neurology (clinical) Radiology medicine.symptom business Blood Flow Velocity Carotid Artery Internal |
Zdroj: | Acta neurochirurgica. 140(9) |
ISSN: | 0001-6268 |
Popis: | Large multicenter studies have recently provided long-term results substantiating the superiority of surgical as compared to conservative treatment for symptomatic and asymptomatic extracranial internal carotid stenoses of more than 70%. These results led to an increase in the frequency of thrombo-endarteriectomies. However, indications are limited by the peri-operative complication rate. This explains the need for intra-operative quality control. The present study compares the standard method of intra-operative quality control in carotid surgery, i.e., intra-operative angiography (IOA), with direct intra-operative Doppler ultrasonography (IDU). Thirty-four patients who underwent carotid thrombo-endarteriectomy (carotid TEA) for a symptomatic (n = 15) or asymptomatic (n = 19) carotid stenosis of more than 70% were submitted to both intra-operative IOA and IDU. The sensitivity and specificity of the two techniques were compared in the light of the intra-operative findings. IDU seems to be superior to IOA in the detection of vasospasm. IOA has a higher sensitivity in demonstrating minisaccules, which, however, are not therapeutically relevant. The other findings obtained with both methods were considered to be of equal value. There were no false negative results by IDU regarding therapeutically relevant findings. We therefore consider it advisable to apply IDU in every case of carotid TEA. IOA should be performed in patients with vessel changes detected by IDU. |
Databáze: | OpenAIRE |
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