Telemedicine-guided carotid and transcranial ultrasound a pilot feasibility study

Robert Mikulik, Andrei Alexandrov, Marc Ribo, Zsolt Garami, Nichole A. Porche, Eva Fulep, James C. Grotta, Anne Alexandrov, John Y. Choi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Purpose - Transcranial Doppler (TCD) and carotid duplex (CD) provide rapid and safe screening for stroke patients but are highly operator dependent. We explored the feasibility of telemedicine (TM)-guided TCD/CD administered by a health care provider inexperienced with ultrasound. Methods - Dual video screens transmitted real-time TCD/CD images and sound to a neurosonographer. TM TCD/CD characteristics were compared with an in-person (IP) examination independently obtained on the same patient. We compared carotid stenosis, thrombolysis in brain ischemia (TIBI) flow grades, and the time spent on testing. Results - We examined 8 subjects with a median age of 51 (31 to 63 range). IP and TM successfully examined 100% of internal carotid and middle cerebral arteries, 50% versus 44% of anterior cerebral artery, and 100% versus 88% of the basilar arteries, respectively. The median time in minutes IP versus TM was 15 (range 10 to 35) and 30 (15 to 50) for CD (P=0.07) and 18 (15 to 30) and 45 (30 to 55) for TCD (P=0.002), respectively. TM correctly identified all normal CD/TCD examinations in 7 subjects. In 1 patient, TM identified carotid occlusion but misread TIBI flow grades in both middle cerebral arteries. Conclusions - Our pilot study showed the feasibility of TCD/CD by an inexperienced health professional guided by a sonographer via TM. Tests were completed within times comparable to outpatient setting in a vascular laboratory.

Original languageEnglish (US)
Pages (from-to)229-230
Number of pages2
JournalStroke
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

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Telemedicine
Feasibility Studies
Middle Cerebral Artery
Brain Ischemia
Anterior Cerebral Artery
Basilar Artery
Carotid Stenosis
Health Personnel
Blood Vessels
Outpatients
Stroke
Health

All Science Journal Classification (ASJC) codes

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

Cite this

Mikulik, R., Alexandrov, A., Ribo, M., Garami, Z., Porche, N. A., Fulep, E., ... Choi, J. Y. (2006). Telemedicine-guided carotid and transcranial ultrasound a pilot feasibility study. Stroke, 37(1), 229-230. https://doi.org/10.1161/01.STR.0000196988.45318.97

Telemedicine-guided carotid and transcranial ultrasound a pilot feasibility study. / Mikulik, Robert; Alexandrov, Andrei; Ribo, Marc; Garami, Zsolt; Porche, Nichole A.; Fulep, Eva; Grotta, James C.; Alexandrov, Anne; Choi, John Y.

In: Stroke, Vol. 37, No. 1, 01.01.2006, p. 229-230.

Research output: Contribution to journalArticle

Mikulik, R, Alexandrov, A, Ribo, M, Garami, Z, Porche, NA, Fulep, E, Grotta, JC, Alexandrov, A & Choi, JY 2006, 'Telemedicine-guided carotid and transcranial ultrasound a pilot feasibility study', Stroke, vol. 37, no. 1, pp. 229-230. https://doi.org/10.1161/01.STR.0000196988.45318.97
Mikulik, Robert ; Alexandrov, Andrei ; Ribo, Marc ; Garami, Zsolt ; Porche, Nichole A. ; Fulep, Eva ; Grotta, James C. ; Alexandrov, Anne ; Choi, John Y. / Telemedicine-guided carotid and transcranial ultrasound a pilot feasibility study. In: Stroke. 2006 ; Vol. 37, No. 1. pp. 229-230.
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