Jang Hun Kim1, Sung-Kon Ha2, Sung-Won Jin3, Hae-Bin Lee4, Sang-Dae Kim4, Se-Hoon Kim4, Dong-Jun Lim4. 1. Trauma Center, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea. 2. Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 15355, Republic of Korea. hasungkon@gmail.com. 3. Department of Neurosurgery, Hando Hospital, Ansan, Gyeonggi-do, Republic of Korea. 4. Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 15355, Republic of Korea.
Abstract
BACKGROUND: Color Doppler ultrasonography (CDUS) is used to evaluate the surgical success and postoperative hemodynamic changes of patients who receive superficial temporal to middle cerebral artery (STA-MCA) bypass surgery. Previous studies enrolled small populations, and difficulties interpreting the results have limited their use in clinical settings. OBJECTIVE: We attempted to determine the feasibility of using CDUS to evaluate STA hemodynamics and identify the most reliable parameter as a new clinical implication for determining bypass patency. METHOD: Twenty-six patients who underwent STA-MCA bypass surgery were prospectively enrolled. Four times CDUS and two times digital subtraction angiography (DSA) were performed. The CDUS parameters were compensated using the ratio of the operated to the non-operated sides (R1) and compared before and after surgery (R2). The CDUS parameters are then compared with the patency on DSA by statistical analyses. RESULTS: Increased CDUS parameters of the mean flow rate (MFR) and cross-sectional diameter (CSD) showed significant correlations with good patency on DSA. The R2 at 1 month was identified as the most reliable parameter for predicting the patency in both MFR and CSD. Their cutoff values were 1.475 and 1.15, respectively. CONCLUSION: CDUS can be utilized for predicting the patency after STA-MCA bypass surgery; if the postoperative (compensated and compared) CDUS parameters increased by more than 47.5% in the MFR or 15% in the CSD, the patency of the anastomosis on DSA would be good.
BACKGROUND: Color Doppler ultrasonography (CDUS) is used to evaluate the surgical success and postoperative hemodynamic changes of patients who receive superficial temporal to middle cerebral artery (STA-MCA) bypass surgery. Previous studies enrolled small populations, and difficulties interpreting the results have limited their use in clinical settings. OBJECTIVE: We attempted to determine the feasibility of using CDUS to evaluate STA hemodynamics and identify the most reliable parameter as a new clinical implication for determining bypass patency. METHOD: Twenty-six patients who underwent STA-MCA bypass surgery were prospectively enrolled. Four times CDUS and two times digital subtraction angiography (DSA) were performed. The CDUS parameters were compensated using the ratio of the operated to the non-operated sides (R1) and compared before and after surgery (R2). The CDUS parameters are then compared with the patency on DSA by statistical analyses. RESULTS: Increased CDUS parameters of the mean flow rate (MFR) and cross-sectional diameter (CSD) showed significant correlations with good patency on DSA. The R2 at 1 month was identified as the most reliable parameter for predicting the patency in both MFR and CSD. Their cutoff values were 1.475 and 1.15, respectively. CONCLUSION: CDUS can be utilized for predicting the patency after STA-MCA bypass surgery; if the postoperative (compensated and compared) CDUS parameters increased by more than 47.5% in the MFR or 15% in the CSD, the patency of the anastomosis on DSA would be good.
Entities:
Keywords:
Anastomosis; Bypass; Color Doppler; MCA; STA; Ultrasonography
Authors: G Gahn; G Hahn; S Hallmeyer-Elgner; A Kunz; T Straube; H Bourquain; H Reichmann; R von Kummer Journal: Cerebrovasc Dis Date: 2001 Impact factor: 2.762