Abstract
The instrumentation and principles of duplex scanning, which combines brightness mode (B-mode) imaging with gated Doppler, has been described in detail in Chap. 5.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982;57:769–774.
Abbott AL. The Natural History of High Grade Asymptomatic Carotid Stenosis and Identification of High Ipsilateral Stroke or TIA Risk Using Microembolus Detection [Ph.D. thesis]. Melbourne: University of Melbourne (Medicine); 2003:439.
Aaslid R. Transcranial Doppler Sonography. Berlin, Germany: Springer/Wien; 1986.
Alexandrov AV. Cerebrovascular Ultrasound in Stroke Prevention and Treatment. Oxford: Futura (Blackwell); 2004.
Schneider PA, Rossman ME, Bernstein EF, Ringelstein EB, Otis SM. Noninvasive assessment of cerebral collateral blood supply through the ophthalmic artery. Stroke. 1991;22:31–36.
Bartels E. Colour-Coded Duplex Ultrasonography of the Cerebral Vessels: Atlas and Manual. Stuttgart: Schattauer; 1999.
Niederkorn K, Myers LG, Nunn CL, Ball MR, McKinney WM. Three-dimensional transcranial Doppler blood flow mapping in patients with cerebrovascular disorders. Stroke. 1988;19:1335–1344.
Gaunt ME et al. Clinical relevance of intraoperative embolization detected by transcranial Doppler ultrasonography during carotid endarterectomy: a prospective study of 100 patients. Br J Surg. 1994;81:1435–1439.
Ackerstaff RG et al. The significance of microemboli detection by means of transcranial Doppler ultrasonography monitoring in carotid endarterectomy. J Vasc Surg. 1995;21:963–969.
Sliwka U et al. Prevalence and time course of microembolic signals in patients with acute stroke. A prospective study. Stroke. 1997;28:358–363.
Koennecke HC et al. Frequency and determinants of microembolic signals on transcranial Doppler in unselected patients with acute carotid territory ischemia. A prospective study. Cerebrovasc Dis. 1998;8:107–112.
Kaposzta Z, Young E, Bath PM, Markus HS. Clinical application of asymptomatic embolic signal detection in acute stroke: a prospective study. Stroke. 1999;30:1814–1818.
Molloy J, Markus HS. Asymptomatic embolization predicts stroke and TIA risk in patients with carotid artery stenosis. Stroke. 1999;30:1440–1443.
Ringelstein EB, Kahlscheuer B, Niggemeyer E, Otis SM. Transcranial Doppler sonography: anatomical landmarks and normal velocity values. Ultrasound Med Biol. 1990;16:745–761.
Nabavi DG et al. Potential and limitations of echocontrast-enhanced ultrasonography in acute stroke patients: a pilot study. Stroke. 1998;29:949–954.
Postert T et al. Contrast-enhanced transcranial color-coded sonography in acute hemispheric brain infarction. Stroke. 1999;30:1819–1826.
Otis S, Rush M, Boyajian R. Contrast-enhanced transcranial imaging. Results of an American phase-two study. Stroke. 1995;26:203–209.
Postert T, Federlein J, Przuntek H, Büttner T. Comparison of transcranial power Doppler and contrast-enhanced color-coded sonography in the identification of intracranial arteries. J Ultrasound Med. 1998;17:91–96.
Kenton AR, Martin PJ, Evans DH. Power Doppler: an advance over colour Doppler for transcranial imaging? Ultrasound Med Biol. 1996;22:313–317.
Lyden PD, Nelson TR. Visualization of the cerebral circulation using three-dimensional transcranial power Doppler ultrasound imaging. J Neuroimaging. 1997;7:35–39.
Newell D, Aaslid R. Transcranial Doppler. New York: Raven; 1992.
Alexandrov AV et al. Practice standards for transcranial Doppler ultrasound: part I – test performance. J Neuroimaging. 2007;17:11–18.
Lindegaard KF et al. Assessment of intracranial hemodynamics in carotid artery disease by transcranial Doppler ultrasound. J Neurosurg. 1985;63:890–898.
Wilterdink JL, Feldmann E, Furie KL, Bragoni M, Benavides JG. Transcranial Doppler ultrasound battery reliably identifies severe internal carotid artery stenosis. Stroke. 1997;28:133–136.
Christou I et al. A broad diagnostic battery for bedside transcranial Doppler to detect flow changes with internal carotid artery stenosis or occlusion. J Neuroimaging. 2001;11:236–242.
Wechsler LR, Ropper AH, Kistler JP. Transcranial Doppler in cerebrovascular disease. Stroke. 1986;17:905–912.
Schneider PA et al. Effect of internal carotid artery occlusion on intracranial hemodynamics. Transcranial Doppler evaluation and clinical correlation. Stroke. 1988;19:589–593.
Kelley RE, Namon RA, Juang SH, Lee SC, Chang JY. Transcranial Doppler ultrasonography of the middle cerebral artery in the hemodynamic assessment of internal carotid artery stenosis. Arch Neurol. 1990;47:960–964.
Kelley RE, Namon RA, Mantelle LL, Chang JY. Sensitivity and specificity of transcranial Doppler ultrasonography in the detection of high-grade carotid stenosis. Neurology. 1993;43:1187–1191.
Wilterdink JL, Feldmann E, Bragoni M, Brooks JM, Benavides JG. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease. J Neuroimaging. 1994;4:196–199.
Hao Q et al. Pilot study of new diagnostic criteria for middle cerebral artery stenosis by transcranial Doppler. J Neuroimaging. 2010;20(2):122–129.
Lindegaard KF, Bakke SJ, Aaslid R, Nornes H. Doppler diagnosis of intracranial artery occlusive disorders. J Neurol Neurosurg Psychiatry. 1986;49:510–518.
Ley-Pozo J, Ringelstein EB. Noninvasive detection of occlusive disease of the carotid siphon and middle cerebral artery. Ann Neurol. 1990;28:640–647.
Wechsler L. Cerebrovascular disease. In: Babikian VL, Weschler LR, eds. Transcranial Doppler Sonography. 2nd ed. Boston: Butterworth-Heinemann; 1999:91–108.
Rorick MB, Nichols FT, Adams RJ. Transcranial Doppler correlation with angiography in detection of intracranial stenosis. Stroke. 1994;25:1931–1934.
Bishop CC, Powell S, Rutt D, Browse NL. Transcranial Doppler measurement of middle cerebral artery blood flow velocity: a validation study. Stroke. 1986;17:913–915.
Arnolds BJ, von Reutern GM. Transcranial Doppler sonography. Examination technique and normal reference values. Ultrasound Med Biol. 1986;12:115–123.
Hennerici M, Rautenberg W, Schwartz A. Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity – part 2. Evaluation of intracranial arterial disease. Surg Neurol. 1987;27:523–532.
Mattle H, Grolimund P, Huber P, Sturzenegger M, Zurbrügg HR. Transcranial Doppler sonographic findings in middle cerebral artery disease. Arch Neurol. 1988;45:289–295.
Thiele BL et al. Standards in noninvasive cerebrovascular testing. Report from the Committee on Standards for Noninvasive Vascular Testing of the Joint Council of the Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery. J Vasc Surg. 1992;15:495–503.
Zanette EM et al. Comparison of cerebral angiography and transcranial Doppler sonography in acute stroke. Stroke. 1989;20:899–903.
Zanette EM et al. Spontaneous middle cerebral artery reperfusion in ischemic stroke. A follow-up study with transcranial Doppler. Stroke. 1995;26:430–443.
Kushner MJ et al. Transcranial Doppler in acute hemispheric brain infarction. Neurology. 1991;41: 109–113.
Lyrer PA, Engelter S, Radü EW, Steck AJ. Cerebral infarcts related to isolated middle cerebral artery stenosis. Stroke. 1997;28:1022–1027.
Röther J, Schwartz A, Wentz KU, Rautenberg W, Hennerici M. Middle cerebral artery stenoses: assessment by magnetic resonance angiography and transcranial Doppler ultrasound. Cerebrovasc Dis. 1994;4:273–279.
Earnest F et al. The accuracy and limitations of intravenous digital subtraction angiography in the evaluation of atherosclerotic cerebrovascular disease: angiographic and surgical correlation. Mayo Clin Proc. 1983;58:735–746.
Austen WG, Howry DH. Ultrasound as a method to detect bubbles or particulate matter in the arterial line during cardiopulmonary bypass. J Surg Res. 1965;5: 283–284.
Spencer MP, Lawrence GH, Thomas GI, Sauvage LR. The use of ultrasonics in the determination of arterial aeroembolism during open-heart surgery. Ann Thorac Surg. 1969;8:489–497.
Padayachee TS et al. The detection of microemboli in the middle cerebral artery during cardiopulmonary bypass: a transcranial Doppler ultrasound investigation using membrane and bubble oxygenators. Ann Thorac Surg. 1987;44:298–302.
Georgiadis D, Grosset DG, Kelman A, Faichney A, Lees KR. Prevalence and characteristics of intracranial microemboli signals in patients with different types of prosthetic cardiac valves. Stroke. 1994;25:587–592.
Markus HS, Droste DW, Brown MM. Detection of asymptomatic cerebral embolic signals with Doppler ultrasound. Lancet. 1994;343:1011–1012.
Droste DW et al. Oxygen inhalation can differentiate gaseous from nongaseous microemboli detected by transcranial Doppler ultrasound. Stroke. 1997;28:2453–2456.
Georgiadis D et al. Influence of oxygen ventilation on Doppler microemboli signals in patients with artificial heart valves. Stroke. 1997;28:2189–2194.
Kaps M et al. Clinically silent microemboli in patients with artificial prosthetic aortic valves are predominantly gaseous and not solid. Stroke. 1997;28:322–325.
Skjelland M et al. Solid cerebral microemboli and cerebrovascular symptoms in patients with prosthetic heart valves. Stroke. 2008;39:1159–1164.
Padayachee TS, Gosling RG, Bishop CC, Burnand K, Browse NL. Monitoring middle cerebral artery blood velocity during carotid endarterectomy. Br J Surg. 1986;73:98–100.
Spencer MP, Thomas GI, Nicholls SC, Sauvage LR. Detection of middle cerebral artery emboli during carotid endarterectomy using transcranial Doppler ultrasonography. Stroke. 1990;21:415–423.
Russell D, Madden KP, Clark WM, Sandset PM, Zivin JA. Detection of arterial emboli using Doppler ultrasound in rabbits. Stroke. 1991;22:253–258.
Markus H, Loh A, Brown MM. Detection of circulating cerebral emboli using Doppler ultrasound in a sheep model. J Neurol Sci. 1994;122:117–124.
Consensus Committee NICHS. Basic identification criteria of Doppler microembolic signals. Stroke. 1995;26:1123.
Molloy J, Markus HS. Multigated Doppler ultrasound in the detection of emboli in a flow model and embolic signals in patients. Stroke. 1996;27:1548–1552.
Moehring MA, Spencer MP. Power M-mode Doppler (PMD) for observing cerebral blood flow and tracking emboli. Ultrasound Med Biol. 2002;28:49–57.
Saqqur M et al. Improved detection of microbubble signals using power M-mode Doppler. Stroke. 2004;35:e14–e17.
Markus HS, Molloy J. Use of a decibel threshold in detecting Doppler embolic signals. Stroke. 1997;28:692–695.
Markus HS et al. Intercenter agreement in reading Doppler embolic signals. A multicenter international study. Stroke. 1997;28:1307–1310.
Van Zuilen EV et al. Automatic embolus detection compared with human experts. A Doppler ultrasound study. Stroke. 1996;27:1840–1843.
Cullinane M, Kaposzta Z, Reihill S, Markus HS. Online automated detection of cerebral embolic signals from a variety of embolic sources. Ultrasound Med Biol. 2002;28:1271–1277.
Steegmann AT, De La Fuente J. Experimental cerebral embolism. II. Microembolism of the rabbit brain with seran polymer resin. J Neuropathol Exp Neurol. 1959;18:537–558.
Luessenhop AJ, Gibbs M, Velasquez AC. Cerebrovascular response to emboli. Observations in patients with arteriovenous malformations. Arch Neurol. 1962;7:264–274.
Winding O. Cerebral microembolization following carotid injection of dextran microspheres in rabbits. Neuroradiology. 1981;21:123–126.
Gaunt ME, Naylor AR, Bell PR. Preventing strokes associated with carotid endarterectomy: detection of embolisation by transcranial Doppler monitoring. Eur J Vasc Endovasc Surg. 1997;14:1–3.
Muth CM, Shank ES. Gas embolism. N Engl J Med. 2000;342:476–482.
Rapp JH et al. Microemboli composed of cholesterol crystals disrupt the blood-brain barrier and reduce cognition. Stroke. 2008;39:2354–2361.
Smith JL, Evans DH, Bell PR, Naylor AR. A comparison of four methods for distinguishing Doppler signals from gaseous and particulate emboli. Stroke. 1998;29:1133–1138.
Russell D, Brucher R. Online automatic discrimination between solid and gaseous cerebral microemboli with the first multifrequency transcranial Doppler. Stroke. 2002;33:1975–1980.
Murphy BP, Harford FJ, Cramer FS. Cerebral air embolism resulting from invasive medical procedures. Treatment with hyperbaric oxygen. Ann Surg. 1985;201:242–245.
Wijman CA, Kase CS, Jacobs AK, Whitehead RE. Cerebral air embolism as a cause of stroke during cardiac catheterization. Neurology. 1998;51:318–319.
Ackerstaff RG et al. Prediction of early cerebral outcome by transcranial Doppler monitoring in carotid bifurcation angioplasty and stenting. J Vasc Surg. 2005;41:618–624.
Kelly GL, Dodi G, Eiseman B. Ultrasound detection of fat emboli. Surg Forum. 1972;23:459–461.
Sylivris S et al. Pattern and significance of cerebral microemboli during coronary artery bypass grafting. Ann Thorac Surg. 1998;66:1674–1678.
Bellapart J, Fraser JF. Transcranial Doppler assessment of cerebral autoregulation. Ultrasound Med Biol. 2009;35: 883–893.
Aaslid R, Lindegaard KF, Sorteberg W, Nornes H. Cerebral autoregulation dynamics in humans. Stroke. 1989;20:45–52.
Widder B, Paulat K, Hackspacher J, Mayr E. Transcranial Doppler CO2 test for the detection of hemodynamically critical carotid artery stenoses and occlusions. Eur Arch Psychiatry Neurol Sci. 1986;236:162–168.
Hartl WH, Furst H. Application of transcranial Doppler sonography to evaluate cerebral hemodynamics in carotid artery disease. Comparative analysis of different hemodynamic variables. Stroke. 1995;26:2293–2297.
Muller M, Voges M, Piepgras U, Schimrigk K. Assessment of cerebral vasomotor reactivity by transcranial Doppler ultrasound and breath-holding. A comparison with acetazolamide as vasodilatory stimulus. Stroke. 1995; 26:96–100.
Rohrberg M, Brodhun R. Measurement of vasomotor reserve in the transcranial Doppler-CO(2) test using an ultrasound contrast agent (Levovist). Stroke. 2001;32:1298–1303.
Pindzola RR, Balzer JR, Nemoto EM, Goldstein S, Yonas H. Cerebrovascular reserve in patients with carotid occlusive disease assessed by stable xenon-enhanced ct cerebral blood flow and transcranial Doppler. Stroke. 2001;32:1811–1817.
Rothwell PM et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet. 2003;361:107–116.
Abbott A, Bladin C, Levi C, Chambers BR. What should we do with asymptomatic carotid stenosis? Int J Stroke. 2007;2:27–39.
Caplan L. Clinical diagnosis of brain embolism. Cerebrovasc Dis. 1995;5:79–88.
Nicolaides AN et al. Angiographic and duplex grading of internal carotid stenosis: can we overcome the confusion? J Endovasc Surg. 1996;3:158–165.
Inzitari D et al. The causes and risk of stroke in patients with asymptomatic internal-carotid-artery stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 2000;342:1693–1700.
MRC European Carotid Surgery Trial. Interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. European Carotid Surgery Trialists’ Collaborative Group. Lancet. 1991;337: 1235–1243.
Johnston SC, Gress DR, Browner WS, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA. 2000;284:2901–2906.
Rothwell PM et al. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet. 2004;363:915–924.
Coull AJ, Lovett JK, Rothwell PM. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ. 2004;328:326.
Valton L, Larrue V, le Traon AP, Massabuau P, Géraud G. Microembolic signals and risk of early recurrence in patients with stroke or transient ischemic attack. Stroke. 1998;29:2125–2128.
Gucuyener D, Uzuner N, Ozkan S, Ozdemir O, Ozdemir G. Micro embolic signals in patients with cerebral ischaemic events. Neurol India. 2001;49:225–230.
Tegos TJ et al. Correlates of embolic events detected by means of transcranial Doppler in patients with carotid atheroma. J Vasc Surg. 2001;33:131–138.
Siebler M, Kleinschmidt A, Sitzer M, Steinmetz H, Freund HJ. Cerebral microembolism in symptomatic and asymptomatic high-grade internal carotid artery stenosis. Neurology. 1994;44:615–618.
Babikian VL, Hyde C, Pochay V, Winter MR. Clinical correlates of high-intensity transient signals detected on transcranial Doppler sonography in patients with cerebrovascular disease. Stroke. 1994;25:1570–1573.
Ries S, Schminke U, Daffertshofer M, Schindlmayr C, Hennerici M. High intensity transient signals and carotid artery disease. Cerebrovasc Dis. 1995;5:124–127.
Sitzer M, Siebler M, Steinmetz H. Silent emboli and their relation to clinical symptoms in extracranial carotid artery disease. Cerebrovasc Dis. 1995;5:121–123.
Markus HS, Thomson ND, Brown MM. Asymptomatic cerebral embolic signals in symptomatic and asymptomatic carotid artery disease. Brain. 1995;118(pt 4):1005–1011.
Droste DW, Dittrich R, Kemény V, Schulte-Altedorneburg G, Ringelstein EB. Prevalence and frequency of microembolic signals in 105 patients with extracranial carotid artery occlusive disease. J Neurol Neurosurg Psychiatry. 1999;67:525–528.
Telman G et al. Determinants of micro-embolic signals in patients with atherosclerotic plaques of the internal carotid artery. Eur J Vasc Endovasc Surg. 2009;38:143–147.
Siebler M, Sitzer M, Steinmetz H. Detection of intracranial emboli in patients with symptomatic extracranial carotid artery disease. Stroke. 1992;23:1652–1654.
Georgiadis D et al. Detection of intracranial emboli in patients with carotid disease. Eur J Vasc Surg. 1994;8:309–314.
Eicke BM, von Lorentz J, Paulus W. Embolus detection in different degrees of carotid disease. Neurol Res. 1995;17:181–184.
Blaser T et al. Time period required for transcranial Doppler monitoring of embolic signals to predict recurrent risk of embolic transient ischemic attack and stroke from arterial stenosis. Stroke. 2004;35:2155–2159.
Abbott AL et al. Embolic signals and prediction of ipsilateral stroke or transient ischemic attack in asymptomatic carotid stenosis: a multicenter prospective cohort study. Stroke. 2005;36:1128–1133.
Orlandi G, Parenti G, Bertolucci A, Murri L. Silent cerebral microembolism in asymptomatic and symptomatic carotid artery stenoses of low and high degree. Eur Neurol. 1997;38:39–43.
Forteza AM, Babikian VL, Hyde C, Winter M, Pochay V. Effect of time and cerebrovascular symptoms of the prevalence of microembolic signals in patients with cervical carotid stenosis. Stroke. 1996;27:687–690.
Wijman CA et al. Cerebral microembolism in patients with retinal ischemia. Stroke. 1998;29:1139–1143.
Censori B, Partziguian T, Casto L, Camerlingo M, Mamoli A. Doppler microembolic signals predict ischemic recurrences in symptomatic carotid stenosis. Acta Neurol Scand. 2000;101:327–331.
Markus HS, MacKinnon A. Asymptomatic embolization detected by Doppler ultrasound predicts stroke risk in symptomatic carotid artery stenosis. Stroke. 2005;36:971–975.
Zuromskis T et al. Prevalence of micro-emboli in symptomatic high grade carotid artery disease: a transcranial Doppler study. Eur J Vasc Endovasc Surg. 2008;35:534–540.
Orlandi G et al. Carotid plaque features on angiography and asymptomatic cerebral microembolism. Acta Neurol Scand. 1997;96:183–186.
Goertler M et al. Reduced frequency of embolic signals in severe carotid stenosis with poststenotic flow velocity reduction. Cerebrovasc Dis. 2005;19:229–233.
Spence JD et al. Effects of intensive medical therapy on microemboli and cardiovascular risk in asymptomatic carotid stenosis. Arch Neurol. 2010;67(2):180–186.
Rothwell PM, Warlow CP. Low risk of ischemic stroke in patients with reduced internal carotid artery lumen diameter distal to severe symptomatic carotid stenosis: cerebral protection due to low poststenotic flow? On behalf of the European carotid surgery trialists’ collaborative group. Stroke. 2000;31:622–630.
Georgiadis D et al. Intracranial microembolic signals in 500 patients with potential cardiac or carotid embolic source and in normal controls. Stroke. 1997;28:1203–1207.
Siebler M, Sitzer M, Rose G, Bendfeldt D, Steinmetz H. Silent cerebral embolism caused by neurologically symptomatic high-grade carotid stenosis. Event rates before and after carotid endarterectomy. Brain. 1993;116(pt 5): 1005–1015.
van Zuilen EV et al. Detection of cerebral microemboli by means of transcranial Doppler monitoring before and after carotid endarterectomy. Stroke. 1995;26:210–213.
Kimura K et al. High intensity transient signals in patients with carotid stenosis may persist after carotid endarterectomy. Cerebrovasc Dis. 2004;17:123–127.
Khaffaf N, Karnik R, Winkler WB, Valentin A, Slany J. Embolic stroke by compression maneuver during transcranial Doppler sonography. Stroke. 1994;25:1056–1057.
Valton L, Larrue V, Arrué P, Géraud G, Bès A. Asymptomatic cerebral embolic signals in patients with carotid stenosis. Correlation with appearance of plaque ulceration on angiography. Stroke. 1995;26:813–815.
Rothwell PM, Gibson R, Warlow CP. Interrelation between plaque surface morphology and degree of stenosis on carotid angiograms and the risk of ischemic stroke in patients with symptomatic carotid stenosis. On behalf of the European Carotid Surgery Trialists’ Collaborative Group. Stroke. 2000;31:615–621.
Sitzer M et al. Plaque ulceration and lumen thrombus are the main sources of cerebral microemboli in high-grade internal carotid artery stenosis. Stroke. 1995;26: 1231–1233.
Siebler M et al. Cerebral microembolism and the risk of ischemia in asymptomatic high-grade internal carotid artery stenosis. Stroke. 1995;26:2184–2186.
Orlandi G, Fanucchi S, Sartucci F, Murri L. Can microembolic signals identify unstable plaques affecting symptomatology in carotid stenosis? Stroke. 2002;33:1744–1746, author reply 1744–1746.
Spence JD, Tamayo A, Lownie SP, Ng WP, Ferguson GG. Absence of microemboli on transcranial Doppler identifies low-risk patients with asymptomatic carotid stenosis. Stroke. 2005;36:2373–2378.
Markus HS et al. Asymptomatic embolisation for prediction of stroke in the asymptomatic carotid emboli study (ACES): a prospective observational study. Lancet Neurol. 2010;9:663–671.
Abbott AL. Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis. Stroke. 2009;40:e573-e583.
Marquardt L, Geraghty OC, Mehta Z, Rothwell PM. Low risk of ipsilateral stroke in patients with asymptomatic carotid stenosis on best medical treatment. A prospective, population-based study. Stroke. 2010;41(1):e11-e17.
Silvestrini M et al. Impaired cerebral vasoreactivity and risk of stroke in patients with asymptomatic carotid artery stenosis. JAMA. 2000;283:2122–2127.
Markus H, Cullinane M. Severely impaired cerebrovascular reactivity predicts stroke and TIA risk in patients with carotid artery stenosis and occlusion. Brain. 2001;124:457–467.
Kaps M, Dorndorf W, Damian MS, Agnoli L. Intracranial haemodynamics in patients with spontaneous carotid dissection. Transcranial Doppler ultrasound follow-up studies. Eur Arch Psychiatry Neurol Sci. 1990;239:246–256.
Achtereekte HA, van der Kruijk RA, Hekster RE, Keunen RW. Diagnosis of traumatic carotid artery dissection by transcranial Doppler ultrasound: case report and review of the literature. Surg Neurol. 1994;42:240–244.
Srinivasan J, Newell DW, Sturzenegger M, Mayberg MR, Winn HR. Transcranial Doppler in the evaluation of internal carotid artery dissection. Stroke. 1996;27:1226–1230.
Molina CA et al. Cerebral microembolism in acute spontaneous internal carotid artery dissection. Neurology. 2000;55:1738–1740.
Roy J, Akhtar N, Watson T, Demchuk AM, Saqqur M. Transcranial Doppler microembolic signal monitoring is useful in diagnosis and treatment of carotid artery dissection: two case reports. J Neuroimaging. 2007;17: 350–352.
Lucas C, Moulin T, Deplanque D, Tatu L, Chavot D. Stroke patterns of internal carotid artery dissection in 40 patients [see comments]. Stroke. 1998;29:2646–2648.
Lyrer P, Engelter S. Antithrombotic drugs for carotid artery dissection. Cochrane Database Syst Rev. 2003;CD000255.
Brunser AM et al. Accuracy of transcranial Doppler compared with ct angiography in diagnosing arterial obstructions in acute ischemic strokes. Stroke. 2009;40:2037–2041.
Demchuk AM et al. Accuracy and criteria for localizing arterial occlusion with transcranial Doppler. J Neuroimaging. 2000;10:1–12.
Alexandrov AV, Demchuk AM, Burgin WS. Insonation method and diagnostic flow signatures for transcranial power motion (M-mode) Doppler. J Neuroimaging. 2002;12:236–244.
Mikulik R, Alexandrov AV. Acute stroke: therapeutic transcranial Doppler sonography. Front Neurol Neurosci. 2006;21:150–161.
Demchuk AM et al. Thrombolysis in brain ischemia (TIBI) transcranial Doppler flow grades predict clinical severity, early recovery, and mortality in patients treated with intravenous tissue plasminogen activator. Stroke. 2001;32:89–93.
Molina CA et al. Improving the predictive accuracy of recanalization on stroke outcome in patients treated with tissue plasminogen activator. Stroke. 2004;35:151–156.
Barreto AD et al. Safety and dose-escalation study design of transcranial ultrasound in clinical sonolysis for acute ischemic stroke: the TUCSON trial. Int J Stroke. 2009;4:42–48.
Alexandrov AV et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med. 2004;351:2170–2178.
Molina CA et al. Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator. Stroke. 2006;37:425–429.
Ferguson GG et al. The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients. Stroke. 1999;30:1751–1758.
Riles TS et al. The cause of perioperative stroke after carotid endarterectomy. J Vasc Surg. 1994;19:206–214, discussion 215–206.
Lennard N et al. Prevention of postoperative thrombotic stroke after carotid endarterectomy: the role of transcranial Doppler ultrasound. J Vasc Surg. 1997;26:579–584.
Spencer MP. Transcranial Doppler monitoring and causes of stroke from carotid endarterectomy. Stroke. 1997;28: 685–691.
de Borst GJ et al. Stroke from carotid endarterectomy: when and how to reduce perioperative stroke rate? Eur J Vasc Endovasc Surg. 2001;21:484–489.
Gaunt ME. Diagnosis of early postoperative carotid artery thrombosis determined by transcranial Doppler scanning. J Vasc Surg. 1994;20:1004–1006.
Gossetti B, Martinelli O, Guerricchio R, Irace L, Benedetti-Valentini F. Transcranial Doppler in 178 patients before, during, and after carotid endarterectomy. J Neuroimaging. 1997;7:213–216.
Feuerstein G, Wang X, Barone FC. Cytokines in brain ischemia – the role of TNF alpha. Cell Mol Neurobiol. 1998;18:695–701.
Dalman JE, Beenakkers IC, Moll FL, Leusink JA, Ackerstaff RG. Transcranial Doppler monitoring during carotid endarterectomy helps to identify patients at risk of postoperative hyperperfusion. Eur J Vasc Endovasc Surg. 1999;18:222–227.
Naylor AR et al. Reducing the risk of carotid surgery: a 7-year audit of the role of monitoring and quality control assessment. J Vasc Surg. 2000;32:750–759.
Ackerstaff RG et al. Association of intraoperative transcranial Doppler monitoring variables with stroke from carotid endarterectomy. Stroke. 2000;31:1817–1823.
Golledge J et al. Determinants of carotid microembolization. J Vasc Surg. 2001;34:1060–1064.
Wolf O et al. Microembolic signals detected by transcranial Doppler sonography during carotid endarterectomy and correlation with serial diffusion-weighted imaging. Stroke. 2004;35:e373-e375.
Skjelland M et al. Cerebral microemboli and brain injury during carotid artery endarterectomy and stenting. Stroke. 2009;40:230–234.
Ogasawara K et al. Intraoperative microemboli and low middle cerebral artery blood flow velocity are additive in predicting development of cerebral ischemic events after carotid endarterectomy. Stroke. 2008;39:3088–3091.
Jansen C et al. Impact of microembolism and hemodynamic changes in the brain during carotid endarterectomy. Stroke. 1994;25:992–997.
Laman DM, Wieneke GH, van Duijn H, van Huffelen AC. High embolic rate early after carotid endarterectomy is associated with early cerebrovascular complications, especially in women. J Vasc Surg. 2002;36:278–284.
Müller M, Behnke S, Walter P, Omlor G, Schimrigk K. Microembolic signals and intraoperative stroke in carotid endarterectomy. Acta Neurol Scand. 1998;97:110–117.
Cantelmo NL et al. Cerebral microembolism and ischemic changes associated with carotid endarterectomy. J Vasc Surg. 1998;27:1024–1030, discussion 1030–1021.
Horn J et al. Identification of patients at risk for ischaemic cerebral complications after carotid endarterectomy with TCD monitoring. Eur J Vasc Endovasc Surg. 2005;30: 270–274.
Abbott AL, Levi CR, Stork JL, Donnan GA, Chambers BR. Timing of clinically significant microembolism after carotid endarterectomy. Cerebrovasc Dis. 2007;23: 362–367.
Levi CR et al. Dextran reduces embolic signals after carotid endarterectomy. Ann Neurol. 2001;50:544–547.
van der Schaaf IC, Horn J, Moll FL, Ackerstaff RG, Antonius Carotid Endarterectomy Angioplasty and Stenting Study Group. Transcranial Doppler monitoring after carotid endarterectomy. Ann Vasc Surg. 2005;19: 19–24.
Stork JL, Levi CR, Chambers BR, Abbott AL, Donnan GA. Possible determinants of early microembolism after carotid endarterectomy. Stroke. 2002;33:2082–2085.
Munts AG, Mess WH, Bruggemans EF, Walda L, Ackerstaff RG. Feasibility and reliability of on-line automated microemboli detection after carotid endarterectomy. A transcranial Doppler study. Eur J Vasc Endovasc Surg. 2003;25:262–266.
Orlandi G et al. Impaired clearance of microemboli and cerebrovascular symptoms during carotid stenting procedures. Arch Neurol. 2005;62:1208–1211.
Caplan LR, Hennerici M. Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Arch Neurol. 1998;55: 1475–1482.
Bernstein M, Fleming JF, Deck JH. Cerebral hyperperfusion after carotid endarterectomy: a cause of cerebral hemorrhage. Neurosurgery. 1984;15:50–56.
Mansoor GA, White WB, Grunnet M, Ruby ST. Intracerebral hemorrhage after carotid endarterectomy associated with ipsilateral fibrinoid necrosis: a consequence of the hyperperfusion syndrome? J Vasc Surg. 1996;23:147–151.
van Mook WN et al. Cerebral hyperperfusion syndrome. Lancet Neurol. 2005;4:877–888.
Wagner WH, Cossman DV, Farber A, Levin PM, Cohen JL. Hyperperfusion syndrome after carotid endarterectomy. Ann Vasc Surg. 2005;19:479–486.
Nyamekye IK, Begum S, Slaney PL. Post-carotid endarterectomy cerebral hyperperfusion syndrome. J R Soc Med. 2005;98:472–474.
Keunen R et al. An observational study of pre-operative transcranial Doppler examinations to predict cerebral hyperperfusion following carotid endarterectomies. Neurol Res. 2001;23:593–598.
Naylor AR et al. Factors influencing the hyperaemic response after carotid endarterectomy. Br J Surg. 1993; 80:1523–1527.
Powers AD, Smith RR. Hyperperfusion syndrome after carotid endarterectomy: a transcranial Doppler evaluation. Neurosurgery. 1990;26:56–59, discussion 59–60.
Jorgensen LG, Schroeder TV. Defective cerebrovascular autoregulation after carotid endarterectomy. Eur J Vasc Surg. 1993;7:370–379.
Jansen C et al. Prediction of intracerebral haemorrhage after carotid endarterectomy by clinical criteria and intraoperative transcranial Doppler monitoring. Eur J Vasc Surg. 1994;8:303–308.
Fujimoto S et al. Diagnostic impact of transcranial color-coded real-time sonography with echo contrast agents for hyperperfusion syndrome after carotid endarterectomy. Stroke. 2004;35:1852–1856.
Ogasawara K et al. Cerebral hyperperfusion following carotid endarterectomy: diagnostic utility of intraoperative transcranial Doppler ultrasonography compared with single-photon emission computed tomography study. AJNR Am J Neuroradiol. 2005;26:252–257.
Markus HS, Harrison MJ, Adiseshiah M. Carotid endarterectomy improves haemodynamics on the contralateral side: implications for operating contralateral to an occluded carotid artery. Br J Surg. 1993;80:170–172.
Hartl WH, Janssen I, Furst H. Effect of carotid endarterectomy on patterns of cerebrovascular reactivity in patients with unilateral carotid artery stenosis. Stroke. 1994; 25:1952–1957.
Vriens EM et al. Flow redistribution in the major cerebral arteries after carotid endarterectomy: a study with transcranial Doppler scan. J Vasc Surg. 2001;33:139–147.
Markus HS, Clifton A, Buckenham T, Brown MM. Carotid angioplasty. Detection of embolic signals during and after the procedure. Stroke. 1994;25:2403–2406.
Jordan WD Jr et al. Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterectomy. Cardiovasc Surg. 1999; 7:33–38.
Marder VJ et al. Analysis of thrombi retrieved from cerebral arteries of patients with acute ischemic stroke. Stroke. 2006;37:2086–2093.
Markus HS et al. Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using Doppler embolic signal detection: the Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis (CARESS) trial. Circulation. 2005;111: 2233–2240.
Goertler M et al. Rapid decline of cerebral microemboli of arterial origin after intravenous acetylsalicylic acid. Stroke. 1999;30:66–69.
van Dellen D et al. Transcranial Doppler ultrasonography-directed intravenous glycoprotein IIb/IIIa receptor antagonist therapy to control transient cerebral microemboli before and after carotid endarterectomy. Br J Surg. 2008;95:709–713.
Junghans U, Siebler M. Cerebral microembolism is blocked by tirofiban, a selective nonpeptide platelet glycoprotein IIb/IIIa receptor antagonist. Circulation. 2003; 107:2717–2721.
Goertler M, Blaser T, Krueger S, Lutze G, Wallesch CW. Acetylsalicylic acid and microembolic events detected by transcranial Doppler in symptomatic arterial stenoses. Cerebrovasc Dis. 2001;11:324–329.
Payne DA et al. Beneficial effects of clopidogrel combined with aspirin in reducing cerebral emboli in patients undergoing carotid endarterectomy. Circulation. 2004; 109:1476–1481.
Kaposzta Z et al. L-arginine and S-nitrosoglutathione reduce embolization in humans. Circulation. 2001;103:2371–2375.
Molloy J, Martin JF, Baskerville PA, Fraser SC, Markus HS. S-nitrosoglutathione reduces the rate of embolization in humans. Circulation. 1998;98:1372–1375.
Kaposzta Z, Clifton A, Molloy J, Martin JF, Markus HS. S-nitrosoglutathione reduces asymptomatic embolization after carotid angioplasty. Circulation. 2002;106:3057–3062.
Meseguer E et al. Prevalence of embolic signals in acute coronary syndromes. Stroke. 2010;41:261–266.
Rothwell PM et al. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet. 2004;363:1925–1933.
Unal B, Critchley JA, Fidan D, Capewell S. Life-years gained from modern cardiological treatments and population risk factor changes in England and Wales, 1981–2000. Am J Public Health. 2005;95:103–108.
King A, Markus HS. Doppler embolic signals in cerebrovascular disease and prediction of stroke risk: a systematic review and meta-analysis. Stroke. 2009;40:3711–3717.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag London Limited
About this chapter
Cite this chapter
Abbott, A.L. (2011). Transcranial Doppler and Cerebrovascular Risk Stratification in Patients with Internal Carotid Artery Atherosclerosis. In: Nicolaides, A., Beach, K., Kyriacou, E., Pattichis, C. (eds) Ultrasound and Carotid Bifurcation Atherosclerosis. Springer, London. https://doi.org/10.1007/978-1-84882-688-5_34
Download citation
DOI: https://doi.org/10.1007/978-1-84882-688-5_34
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84882-687-8
Online ISBN: 978-1-84882-688-5
eBook Packages: MedicineMedicine (R0)