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Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation  Shigeki Morita, MD, PhD, Masahiro Yasaka, MD, PhD,

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Presentation on theme: "Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation  Shigeki Morita, MD, PhD, Masahiro Yasaka, MD, PhD,"— Presentation transcript:

1 Transcranial Doppler Study to Assess Intracranial Arterial Communication Before Aortic Arch Operation  Shigeki Morita, MD, PhD, Masahiro Yasaka, MD, PhD, Kotaro Yasumori, MD, PhD, Yasuhisa Oishi, MD, PhD, Toru Takaseya, MD, PhD, Hiromichi Sonoda, MD, PhD, Takemi Kawara, MD, PhD  The Annals of Thoracic Surgery  Volume 86, Issue 2, Pages (August 2008) DOI: /j.athoracsur Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Bilateral axillary perfusion shows the selective perfusion of the left common carotid artery during an aortic arch procedure. (B) The question remains regarding whether it is safe to interrupt the perfusion to the left common carotid artery. It is necessary to determine whether the left middle cerebral artery would be perfused through the cross-communicating arteries. Arrows indicate presence of blood flow in the arteries. Question marks indicate whether or not blood flow exists during the occlusion of the left carotid artery. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Two examples of the flow pattern of the left middle cerebral artery are shown. In case A, the flow of the left middle cerebral artery was maintained during the left common carotid artery compression. In case B, the left middle cerebral artery flow completely disappeared during the left common carotid artery compression. O and X indicate “good” and “poor” collateral flow to the left middle cerebral artery, respectively. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 The left middle cerebral artery flow during the left common carotid artery compression was expressed as a percent of the precompression value (%LMCA flow) and sorted according to the value of %LMCA flow. Note that the values of %LMCA were highly variable. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 The relationship between age and the left middle cerebral artery flow during the left common carotid artery compression expressed as a percent of the precompression value (%LMCA flow) flow is shown. The correlation constant between the %LMCA flow and age was weak (r = −0.43). Each circle indicates an individual patient. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 The patients were grouped based on the findings of magnetic resonance angiography, namely, as having good, fair, and poor cross-circulation to the left middle cerebral artery. The findings were related to the %LMCA flow. Each circle indicates an individual patient. (%LMCA = the left middle cerebral artery flow during the left common carotid artery compression expressed as a percent of the precompression value.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

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