Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients
Autor: | Jonathan Streifler, Stefan T. Engelter, Philippe Lyrer, Christopher Traenka |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Cervical Artery Carotid Artery Internal Dissection 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Recurrence Interquartile range Occlusion Vertebrobasilar Insufficiency medicine Humans Carotid Stenosis Registries Artery occlusion Ultrasonography Doppler Color Vascular Patency Retrospective Studies Vertebral Artery Dissection business.industry Ultrasound Middle Aged Prognosis medicine.anatomical_structure Neurology Duplex (building) Cerebrovascular Circulation Female Neurology (clinical) Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Switzerland 030217 neurology & neurosurgery Artery |
Zdroj: | Cerebrovascular Diseases. 49:206-215 |
ISSN: | 1421-9786 1015-9770 |
Popis: | Purpose: To study the clinical usefulness of serial color-coded duplex ultrasound (DUS) examinations in cervical artery dissection (CeAD) patients. Methods: Single-center, CeAD registry-based re-review of serial, routine DUS exams in consecutive CeAD patients treated at the Stroke Center Basel, Switzerland (2009–2015). Two experienced raters reassessed all DUS for the occurrence of new arterial findings during follow-up, that is. (i) recanalization of the dissected artery (if occluded at baseline), (ii) delayed occlusion of a patent dissected artery, and (iii) recurrent CeAD. We studied whether these new arterial findings were associated with clinical symptoms. Results: In 94 CeAD patients (n = 40 female [42.6%], median age 46 years [interquartile range (IQR) 36.2–53]), 506 DUS examinations were reviewed covering a median length of follow-up of 54.1 weeks (IQR 30.5–100.5). In total, 105 dissected arteries were detected, of which 27 (25.7%) were occluded. In 28/94 patients (29.8%), 31 new arterial findings were recorded, which were associated with clinical symptoms in 9/31 (30%) patients. Recanalization of occluded CeAD was observed in 22/27 (81.5%) arteries and occurred in 20/22 arteries within 3 months. In 4/22 patients (18.2%), recanalization was associated with clinical symptoms (ischemic events [n = 2], pure local symptoms [n = 2]). Delayed occlusions were observed in 4/78 (5.1%) dissected arteries patent at baseline. All were clinically asymptomatic and occurred within 14 days from baseline. Recurrent CeAD (all symptomatic) occurred in 5 previously non-dissected arteries. Conclusion: In CeAD patients, follow-up DUS identified new arterial findings, of which several were associated with clinical symptoms: we found that about 1 of 5 recanalizations were associated with clinical symptoms, of whom half were ischemic symptoms. Further, delayed occlusions occurred in patients with no or mild stenosis at baseline and were asymptomatic. This study emphasizes the potential importance of repeated DUS in CeAD particularly in the early phase of up to 4 weeks. |
Databáze: | OpenAIRE |
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