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Evaluation of posterior cerebral artery blood flow with transcranial Doppler sonography: Value and risk of common carotid artery compression
Author(s) -
Jatuzis Dalius,
Zachrisson Helene,
Blomstrand Christian,
Ekholm Sven,
Holm Jan,
Volkmann Reinhard
Publication year - 2000
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/1097-0096(200011/12)28:9<452::aid-jcu2>3.0.co;2-6
Subject(s) - medicine , circle of willis , transcranial doppler , posterior cerebral artery , common carotid artery , internal carotid artery , cerebral arteries , radiology , blood flow , posterior communicating artery , cardiology , middle cerebral artery , carotid arteries , ischemia
Purpose Investigations of the posterior cerebral arteries (PCA) by transcranial Doppler sonography (TCD) may be less reliable than investigations of the anterior part of the circle of Willis. Nevertheless, a true PCA may be identified by manual compression of the proximal common carotid artery (CCA) during TCD. Therefore, we used CCA compression in clinically indicated TCD studies and assessed retrospectively its risks and prospectively its benefits for PCA evaluations. Methods Using the transtemporal approach, we prospectively assessed flow velocities in posteriorly located blood vessels in 180 consecutive patients before and during CCA compression. The complications of CCA compression were retrospectively reviewed in all 3,383 clinical TCD investigations performed over an 8‐year period. Results Decreased flow velocities during ipsilateral CCA compression occurred in 17% of patients. A PCA‐like vessel with perfusion from the carotid artery or PCA supply from the carotid circulation was unmasked. Mixed distal PCA support by the posterior communicating artery and proximal PCA could not be shown by TCD. Transient cerebral symptoms occurred in less than 0.4% of the 3,383 retrospectively reviewed TCD investigations; no other adverse effects were seen. Conclusions TCD without CCA compression may lead to false identification of the PCA. Since transient cerebral symptoms during CCA compression are rare, CCA compression can be used when a clinical TCD investigation of intracranial collateral blood flow compensation is indicated or when the identification of a cerebral artery is uncertain. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:452–460, 2000