Detection of Reversed Basilar Flow with Power-Motion Doppler after Acute Occlusion Predicts Favorable Outcome

Marc Ribo, Zsolt Garami, Ken Uchino, Joon Song, Carlos A. Molina, Andrei Alexandrov

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background and Purpose-Power-motion transcranial Doppler PMD-TCD is a new method for simultaneous display of flow at multiple depths. We aimed to determine clinical significance of PMD-TCD demonstration of reversed basilar flow in patients with basilar artery (BA) occlusion. Methods-We prospectively evaluated patients with acute vertebrobasilar ischemia using PMD-TCD. Using a predefined set of TCD depth criteria and specific flow findings, occlusion was localized to the proximal, middle, or distal BA stem. The National Institutes of Health Stroke Scale was used to measure stroke severity and the modified Rankin Scale (mRS) to assess outcome at 3 months. Results-BA occlusion was diagnosed in 16 patients (3 women, mean age 65, median NIHSS 8, mean time from symptoms onset 8.5 hours). PMD-TCD diagnosis of BA occlusion was confirmed in 11 of 12 patients who underwent invasive angiography. Reversed BA flow on PMD-TCD was identified in 8 patients (50%). Angiography confirmed flow from carotid system in 6 of these 8 patients (κ=0.87). Patients with reversed BA flow showed lower NIHSS scores on admission (median 4 versus 15.5, P=0.009), on discharge (2 versus 21.5, P=0.03) and did not experience neurological deterioration during hospital stay (n=0 versus 4, P=0.05). There was a trend toward better outcome at 3 months (mRS 1 versus 4, P=0.07). Conclusion-Detection of reversed flow in the distal BA with PMD-TCD is associated with lower stroke severity and better outcome after acute basilar artery occlusion.

Original languageEnglish (US)
Pages (from-to)79-82
Number of pages4
JournalStroke
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Basilar Artery
Stroke
Angiography
Vertebrobasilar Insufficiency
National Institutes of Health (U.S.)
Length of Stay

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Detection of Reversed Basilar Flow with Power-Motion Doppler after Acute Occlusion Predicts Favorable Outcome. / Ribo, Marc; Garami, Zsolt; Uchino, Ken; Song, Joon; Molina, Carlos A.; Alexandrov, Andrei.

In: Stroke, Vol. 35, No. 1, 01.01.2004, p. 79-82.

Research output: Contribution to journalArticle

Ribo, Marc ; Garami, Zsolt ; Uchino, Ken ; Song, Joon ; Molina, Carlos A. ; Alexandrov, Andrei. / Detection of Reversed Basilar Flow with Power-Motion Doppler after Acute Occlusion Predicts Favorable Outcome. In: Stroke. 2004 ; Vol. 35, No. 1. pp. 79-82.
@article{fd47d9d6b02c49b0ba7710077edf9d36,
title = "Detection of Reversed Basilar Flow with Power-Motion Doppler after Acute Occlusion Predicts Favorable Outcome",
abstract = "Background and Purpose-Power-motion transcranial Doppler PMD-TCD is a new method for simultaneous display of flow at multiple depths. We aimed to determine clinical significance of PMD-TCD demonstration of reversed basilar flow in patients with basilar artery (BA) occlusion. Methods-We prospectively evaluated patients with acute vertebrobasilar ischemia using PMD-TCD. Using a predefined set of TCD depth criteria and specific flow findings, occlusion was localized to the proximal, middle, or distal BA stem. The National Institutes of Health Stroke Scale was used to measure stroke severity and the modified Rankin Scale (mRS) to assess outcome at 3 months. Results-BA occlusion was diagnosed in 16 patients (3 women, mean age 65, median NIHSS 8, mean time from symptoms onset 8.5 hours). PMD-TCD diagnosis of BA occlusion was confirmed in 11 of 12 patients who underwent invasive angiography. Reversed BA flow on PMD-TCD was identified in 8 patients (50{\%}). Angiography confirmed flow from carotid system in 6 of these 8 patients (κ=0.87). Patients with reversed BA flow showed lower NIHSS scores on admission (median 4 versus 15.5, P=0.009), on discharge (2 versus 21.5, P=0.03) and did not experience neurological deterioration during hospital stay (n=0 versus 4, P=0.05). There was a trend toward better outcome at 3 months (mRS 1 versus 4, P=0.07). Conclusion-Detection of reversed flow in the distal BA with PMD-TCD is associated with lower stroke severity and better outcome after acute basilar artery occlusion.",
author = "Marc Ribo and Zsolt Garami and Ken Uchino and Joon Song and Molina, {Carlos A.} and Andrei Alexandrov",
year = "2004",
month = "1",
day = "1",
doi = "10.1161/01.STR.0000106760.25228.2C",
language = "English (US)",
volume = "35",
pages = "79--82",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Detection of Reversed Basilar Flow with Power-Motion Doppler after Acute Occlusion Predicts Favorable Outcome

AU - Ribo, Marc

AU - Garami, Zsolt

AU - Uchino, Ken

AU - Song, Joon

AU - Molina, Carlos A.

AU - Alexandrov, Andrei

PY - 2004/1/1

Y1 - 2004/1/1

N2 - Background and Purpose-Power-motion transcranial Doppler PMD-TCD is a new method for simultaneous display of flow at multiple depths. We aimed to determine clinical significance of PMD-TCD demonstration of reversed basilar flow in patients with basilar artery (BA) occlusion. Methods-We prospectively evaluated patients with acute vertebrobasilar ischemia using PMD-TCD. Using a predefined set of TCD depth criteria and specific flow findings, occlusion was localized to the proximal, middle, or distal BA stem. The National Institutes of Health Stroke Scale was used to measure stroke severity and the modified Rankin Scale (mRS) to assess outcome at 3 months. Results-BA occlusion was diagnosed in 16 patients (3 women, mean age 65, median NIHSS 8, mean time from symptoms onset 8.5 hours). PMD-TCD diagnosis of BA occlusion was confirmed in 11 of 12 patients who underwent invasive angiography. Reversed BA flow on PMD-TCD was identified in 8 patients (50%). Angiography confirmed flow from carotid system in 6 of these 8 patients (κ=0.87). Patients with reversed BA flow showed lower NIHSS scores on admission (median 4 versus 15.5, P=0.009), on discharge (2 versus 21.5, P=0.03) and did not experience neurological deterioration during hospital stay (n=0 versus 4, P=0.05). There was a trend toward better outcome at 3 months (mRS 1 versus 4, P=0.07). Conclusion-Detection of reversed flow in the distal BA with PMD-TCD is associated with lower stroke severity and better outcome after acute basilar artery occlusion.

AB - Background and Purpose-Power-motion transcranial Doppler PMD-TCD is a new method for simultaneous display of flow at multiple depths. We aimed to determine clinical significance of PMD-TCD demonstration of reversed basilar flow in patients with basilar artery (BA) occlusion. Methods-We prospectively evaluated patients with acute vertebrobasilar ischemia using PMD-TCD. Using a predefined set of TCD depth criteria and specific flow findings, occlusion was localized to the proximal, middle, or distal BA stem. The National Institutes of Health Stroke Scale was used to measure stroke severity and the modified Rankin Scale (mRS) to assess outcome at 3 months. Results-BA occlusion was diagnosed in 16 patients (3 women, mean age 65, median NIHSS 8, mean time from symptoms onset 8.5 hours). PMD-TCD diagnosis of BA occlusion was confirmed in 11 of 12 patients who underwent invasive angiography. Reversed BA flow on PMD-TCD was identified in 8 patients (50%). Angiography confirmed flow from carotid system in 6 of these 8 patients (κ=0.87). Patients with reversed BA flow showed lower NIHSS scores on admission (median 4 versus 15.5, P=0.009), on discharge (2 versus 21.5, P=0.03) and did not experience neurological deterioration during hospital stay (n=0 versus 4, P=0.05). There was a trend toward better outcome at 3 months (mRS 1 versus 4, P=0.07). Conclusion-Detection of reversed flow in the distal BA with PMD-TCD is associated with lower stroke severity and better outcome after acute basilar artery occlusion.

UR - http://www.scopus.com/inward/record.url?scp=0346726104&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0346726104&partnerID=8YFLogxK

U2 - 10.1161/01.STR.0000106760.25228.2C

DO - 10.1161/01.STR.0000106760.25228.2C

M3 - Article

VL - 35

SP - 79

EP - 82

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -