Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy

Background and Purpose Transcranial Doppler (TCD) identifies acute stroke patients with arterial occlusion where treatment may not effectively open the blocked vessel. This study aimed to examine the clinical utility and prognostic value of TCD flow findings in patients enrolled in a multicenter pro...

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Published in:Journal of neuroimaging 2024-07, Vol.34 (4), p.430-437
Main Authors: Khan, Adnan, Saqqur, Maher, Shuaib, Ashfaq, Khan, Khurshid, Sharma, Vijay K., Brunser, Alejandro, Eggers, Jürgen, Mikulik, Robert, Katsanos, Aristeidis H., Sergentanis, Theodore N., Vadikolias, Konstantinos, Rubiera, Marta, Shahripour, Reza Bavarsad, Nguyen, Huy Thang, Martínez‐Sánchez, Patricia, Safouris, Apostolos, Heliopoulos, Ioannis, Salam, Abdul, Derksen, Carol, Voumvourakis, Konstantinos, Psaltopoulou, Theodora, Alexandrov, Anne W., Alexandrov, Andrei V., Tsivgoulis, Georgios
Format: Article
Language:English
Subjects:
Angiography
Blood vessels
Carotid arteries
Carotid artery
Cerebral blood flow
Computed tomography
Evaluation
Flow velocity
Intravenous administration
Ischemia
Lysis
mRS
Occlusion
Patients
reperfusion
Stroke
thrombectomy
Thrombolysis
TIBI
tPA
transcranial Doppler
Ultrasound
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Summary:Background and Purpose Transcranial Doppler (TCD) identifies acute stroke patients with arterial occlusion where treatment may not effectively open the blocked vessel. This study aimed to examine the clinical utility and prognostic value of TCD flow findings in patients enrolled in a multicenter prospective study (CLOTBUST‐PRO). Methods Patients enrolled with intracranial occlusion on computed tomography angiography (CTA) who underwent urgent TCD evaluation before intravenous thrombolysis was included in this analysis. TCD findings were assessed using the mean flow velocity (MFV) ratio, comparing the reciprocal ratios of the middle cerebral artery (MCA) depths bilaterally (affected MCA‐to‐contralateral MCA MFV [aMCA/cMCA MFV ratio]). Results A total of 222 patients with intracranial occlusion on CTA were included in the study (mean age: 64 ± 14 years, 62% men). Eighty‐eight patients had M1 MCA occlusions; baseline mean National Institutes of Health Stroke Scale (NIHSS) score was 16, and a 24‐hour mean NIHSS score was 10 points. An aMCA/cMCA MFV ratio of
ISSN:1051-2284
1552-6569
1552-6569
DOI:10.1111/jon.13207