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Titolo:
RELATIONSHIP OF TRANSCRANIAL DOPPLER FLOW VELOCITIES AND ARTERIOVENOUS MALFORMATION FEEDING ARTERY PRESSURES
Autore:
FLEISCHER LH; YOUNG WL; PILESPELLMAN J; TERPENNING B; KADER A; STEIN BM; MOHR JP;
Indirizzi:
COLUMBIA PRESBYTERIAN MED CTR,161 FT WASHINGTON AVE,ROOM 901 NEW YORKNY 10032 COLUMBIA UNIV COLL PHYS & SURG,DEPT ANESTHESIOL NEW YORK NY 10032 COLUMBIA UNIV COLL PHYS & SURG,DEPT RADIOL NEW YORK NY 10032 COLUMBIA UNIV COLL PHYS & SURG,DEPT NEUROL SURG NEW YORK NY 10032 COLUMBIA UNIV COLL PHYS & SURG,DEPT NEUROL NEW YORK NY 10032
Titolo Testata:
Stroke
fascicolo: 12, volume: 24, anno: 1993,
pagine: 1897 - 1902
SICI:
0039-2499(1993)24:12<1897:ROTDFV>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMBOLIZATION; HEMORRHAGE; SIZE; AVMS;
Keywords:
ARTERIOVENOUS MALFORMATIONS; CEREBRAL ARTERIES; INTRACRANIAL HEMORRHAGE; ULTRASONICS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
L.H. Fleischer et al., "RELATIONSHIP OF TRANSCRANIAL DOPPLER FLOW VELOCITIES AND ARTERIOVENOUS MALFORMATION FEEDING ARTERY PRESSURES", Stroke, 24(12), 1993, pp. 1897-1902

Abstract

Background and Purpose: Feeding mean arterial pressure immediately proximal to the nidus of arteriovenous malformations may influence the frequency of spontaneous intracerebral hemorrhage. This study assessed the usefulness of transcranial Doppler ultrasound velocities as a noninvasive estimate of feeding mean arterial pressure. Methods: We studied 41 patients undergoing 73 staged treatments of arteriovenous malformations with endovascular embolization, surgery, or both. Before treatment during the awake state, transcranial Doppler mean and peak velocities were recorded in proximal Willisian vessels. During superselectiveangiography with the patient under conscious sedation or during surgery with the patient under general anesthesia, feeding mean arterial pressure was measured through a 1.5F transfemoral intracranial microcatheter or a 26-g needle by direct puncture. Measurement of insonated artery diameter was possible in 41 embolizations, and a flow velocity index (mL/min) and Reynolds' number were estimated. Results: Mean+/-SEM feeding mean arterial pressure was 38+/-2 mm Hg at a systemic mean arterial pressure of 77+/-2 mm Hg; mean velocity was 102+/-4 cm/s. There was an inverse correlation between feeding mean arterial pressure and parent artery mean velocity (y=-0.74x+130, r=.35. P=.0025). The best correlation was for the first treatment in each patient (n=27) using thehighest peak velocity obtainable in a Willisian vessel ipsilateral tothe arteriovenous malformation (y=-1.61x+221, r=.62, P=.0005). Flow velocity index (775+/-106 mL/min) did not correlate with feeding mean arterial pressure, but there was a weak correlation with Reynolds' number (y=-12x+1616, r=.27, P=.1283). Mean Reynolds' number was 1257+/-119. Conclusions: Transcranial Doppler mean velocity is correlated with feeding mean arterial pressure but only weakly predictive. Considerations influencing the relation of distal feeding mean arterial pressure to proximal mean velocity might include the influence of other fistulaein the circuit between major inflow and outflow channels as well as turbulent flow at vascular branch points between point of insonation and the nidus, as suggested by Reynolds' number values of more than 400.

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Documento generato il 29/11/20 alle ore 06:43:56