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Intraoperative doppler transcranial

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https://www.readbyqxmd.com/read/27566804/intraoperative-neuromonitoring-in-major-vascular-surgery
#1
V C So, C C M Poon
There has been a growing interest in using intraoperative neuromonitoring to reduce the incidence of stroke and paralysis in major vascular interventions. Electroencephalography, various neurophysiological evoked potential measurements, transcranial Doppler, and near-infrared spectroscopy are some of the modalities currently used to detect neural injuries. A good understanding of these modalities and their interactions with anaesthesia is important to maximize their value and to allow meaningful interpretation of their results...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27283935/cerebral-microembolization-during-aortic-valve-replacement-using-minimally-invasive-or-conventional-extracorporeal-circulation-a-randomized-trial
#2
Reto Basciani, Felix Kröninger, Erich Gygax, Hansjörg Jenni, David Reineke, Monika Stucki, Niels Hagenbuch, Thierry Carrel, Balthasar Eberle, Gabor Erdoes
To compare intraoperative cerebral microembolic load between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) during isolated surgical aortic valve replacement (SAVR), we conducted a randomized trial in patients undergoing primary elective SAVR at a tertiary referral hospital. The primary outcome was the procedural phase-related rate of high-intensity transient signals (HITS) on transcranial Doppler ultrasound. HITS rate was used as a surrogate of cerebral microembolism in pre-defined procedural phases in SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with integrated arterial filter...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/26902940/feasibility-and-safety-of-simultaneous-carotid-endarterectomy-and-carotid-stenting-for-bilateral-carotid-stenosis-a-single-center-experience-using-a-hybrid-procedure
#3
Rong-Wei Xu, Peng Liu, Xue-Qiang Fan, Qian Wang, Jian-Bin Zhang, Zhi-Dong Ye
BACKGROUND: The treatment for bilateral carotid stenosis (BCS) is challenging, and the optimal treatment strategy is not clear. We report our experience of treating 8 patients with BCS by simultaneous carotid endarterectomy (CEA) and carotid stenting (CAS), thereby providing an alternative for vascular surgeons. METHODS: Between October 2010 and August 2014, 8 patients (5 males and 3 females; range, 53-82 years; mean, 69 ± 8.8 years) underwent simultaneous CEA and CAS in our hospital...
May 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26898919/digital-carotid-compression-a-simple-method-to-reduce-solid-cerebral-emboli-during-cardiac-surgery
#4
Julia Hillebrand, Amin Rouhollahpour, Andreas Zierer, Anton Moritz, Sven Martens
OBJECTIVES: Serious neurologic injury can be attributed to embolization of solid particles into cerebral vessels during cardiac surgery. Previous studies using transcranial Doppler (TCD) identified arterial cannulation and aortic declamping to be associated with cerebral embolization. The purpose of this study was to investigate the impact of transient compression of the carotid arteries during these maneuvers on the embolic load during cardiac surgery with cardiopulmonary bypass. DESIGN: Prospective, randomized, clinical trial/pilot study...
April 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26889442/selective-carotid-shunting-based-on-intraoperative-transcranial-doppler-imaging-during-carotid-endarterectomy-a-retrospective-single-center-review
#5
Jun Woo Cho, Yun-Ho Jeon, Chi Hoon Bae
BACKGROUND: Carotid endarterectomy (CEA) with selective shunting is the surgical method currently used to treat patients with carotid artery disease. We evaluated the incidence of major postoperative complications in patients who underwent CEA with selective shunting under transcranial Doppler (TCD) at our institution. METHODS: The records of 45 patients who underwent CEA with TCD-based selective shunting under general anesthesia from November 2009 to June 2015 were reviewed...
February 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26879693/the-effect-of-blood-pressure-and-cardiac-output-on-the-quality-of-the-surgical-field-and-middle-cerebral-artery-blood-flow-during-endoscopic-sinus-surgery
#6
Thanh Ngoc Ha, Robert Graham van Renen, Guy L Ludbrook, Peter-John Wormald
BACKGROUND: A clear surgical field is critical during endoscopic sinus surgery (ESS). Hypotensive anesthesia and cardiac output (CO) may optimize the surgical field; however, evidence of their effect on bleeding and cerebral blood flow is conflicting. The aim of this study was to evaluate the effect of blood pressure (BP) and CO on intraoperative bleeding and middle cerebral artery blood flow velocity (Vmca ) during ESS. METHODS: This was a prospective randomized controlled trial...
July 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/26794908/transcervical-carotid-stenting-with-dynamic-flow-reversal-demonstrates-embolization-rates-comparable-to-carotid-endarterectomy
#7
Maarten Plessers, Isabelle Van Herzeele, Dimitri Hemelsoet, Nikil Patel, Emma M L Chung, Guy Vingerhoets, Frank Vermassen
PURPOSE: To evaluate a series of patients treated electively with carotid endarterectomy (CEA), transfemoral carotid artery stenting with distal filter protection (CASdp), and transcervical carotid stenting with dynamic flow reversal (CASfr) monitored continuously with transcranial Doppler (TCD) during the procedure to detect intraoperative embolization rates. METHODS: Thirty-four patients (mean age 67.6 years; 24 men) with significant carotid stenosis underwent successful TCD monitoring during the revascularization procedure (10 CEA, 8 CASdp, and 16 CASfr)...
April 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/26783262/intraoperative-embolization-and-cognitive-decline-after-cardiac-surgery-a-systematic-review
#8
REVIEW
Nikil Patel, Jatinder S Minhas, Emma M L Chung
Since the advent of cardiac surgery, complications have existed in many forms. Recent work has focused on the safety of current cardiac surgery with particular emphasis on cognitive outcomes. Cardiopulmonary bypass has improved the safety of operative practice; however, increasing concern surrounds the measurable and immeasurable impact embolization has on the brain. New ischemic lesions have been associated with distant emboli, which intraoperatively enter the cardiovascular system. This has prompted better characterization of the nature of emboli manifesting as cognitive impairment postoperatively...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26771727/transcranial-doppler-and-diffusion-weighted-magnetic-resonance-evaluation-of-cerebral-embolization-occurring-during-transfemoral-carotid-stenting-with-proximal-flow-blockage
#9
Giovanni Palombo, Nazzareno Stella, Cristiano Fantozzi, Alessandro Bozzao, Maurizio Taurino
BACKGROUND: Transfemoral carotid artery stenting (CAS) with endovascular proximal flow blockage is deemed able to reduce the cerebral embolization observed during filter-protected CAS. We evaluated clinical outcome and intraoperative embolization rates, measured by diffusion-weighted magnetic resonance imaging (DW-MRI) and transcranial Doppler monitoring, in a series of patients undergoing CAS with proximal flow blockage. METHODS: A series of 35 consecutive patients with symptomatic or asymptomatic internal carotid artery stenosis ≥70% were included to undergo CAS with proximal flow blockage, obtained with the Mo...
February 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/26723102/outer-ear-canal-sound-pressure-and-bone-vibration-measurement-in-ssd-and-chl-patients-using-a-transcutaneous-bone-conduction-instrument
#10
Mohammad Ghoncheh, Giorgio Lilli, Thomas Lenarz, Hannes Maier
The intraoperative and postoperative objective functional assessment of transcutaneous bone conduction implants is still a challenge. Here we compared intraoperative Laser-Doppler-vibrometry (LDV, Polytec Inc.) to measure vibration of the bone close to the implant to Outer Ear Canal Sound Pressure Level (OEC-SPL) measurements. Twelve single sided deafness (SSD) patients with contralateral intact ossicular chains and eight bilateral conductive hearing loss (CHL) patients were included in the study. SSD patients had a minor average air-bone-gap (ABG) of 0...
December 23, 2015: Hearing Research
https://www.readbyqxmd.com/read/26486239/hemodynamic-considerations-during-carotid-endarterectomy
#11
G E Esses, V Babikian, N L Cantelmo, M Saint-Hilaire, V E Pochay, W C Johnson
To evaluate the hemodynamic and angiographic characteristics of patients undergoing carotid endarterectomy, we reviewed the medical records, angiograms, transcranial Doppler ultrasound data, and EEGs of 42 consecutive patients having 44 carotid endarterectomies. Significant (p < 0.0002) changes in the peak systolic velocity of the middle cerebral artery ipsilateral to the side of surgery (iMCAFV) occurred with anesthesia, carotid clamping, shunting, and the release of clamps. Thirteen percent of patients with collateral flow toward the side of surgery and 57% of those with flow away from the operated side had a drop in iMCAFV exceeding 50% of the baseline value (p = 0...
1994: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/26384626/intraoperative-cerebral-autoregulation-assessment-using-ultrasound-tagged-near-infrared-based-cerebral-blood-flow-in-comparison-to-transcranial-doppler-cerebral-flow-velocity-a-pilot-study
#12
COMPARATIVE STUDY
John M Murkin, Moshe Kamar, Zmira Silman, Michal Balberg, Sandra J Adams
OBJECTIVE: This was a pilot study comparing the ability of a new ultrasound-tagged near-infrared (UT-NIR) device to detect cerebral autoregulation (CA) in comparison to transcranial Doppler (TCD). DESIGN: An unblinded, prospective, clinical feasibility study. SETTING: Tertiary-care university hospital cardiac surgical operating rooms. PARTICIPANTS: Twenty adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB)...
October 2015: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26342642/intraoperative-non-invasive-intracranial-pressure-monitoring-during-pneumoperitoneum-a-case-report-and-a-review-of-the-published-cases-and-case-report-series
#13
REVIEW
C Robba, S Bacigaluppi, D Cardim, J Donnelly, M S Sekhon, M J Aries, G Mancardi, A Booth, N L Bragazzi, M Czosnyka, B Matta
Non-invasive measurement of ICP (nICP) can be warranted in patients at risk for developing increased ICP during pneumoperitoneum (PP). Our aim was to assess available data on the application of nICP monitoring during these procedures and to present a patient assessed with an innovative combination of noninvasive tools. Literature review of nICP assessment during PP did not find any studies comparing different methods intraprocedurally and only few studies of any nICP monitoring were available: transcranial Doppler (TCD) studies used the pulsatility index (PI) as an estimator of ICP and failed to detect a significant ICP increase during PP, whereas two out of three optic nerve sheath diameter (ONSD) studies detected a statistically significant ICP increase...
October 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/26118926/anesthesia-for-liver-transplantation
#14
REVIEW
Aparna Dalal
Patients with end stage liver disease (ESLD) have complex problems such as cirrhotic cardiomyopathy, coronary artery disease, hepatopulmonary syndrome (HPS), portopulmonary hypertension (POPH), hepatic encephalopathy, intracranial hypertension, (ICP), left ventricular outflow tract obstruction (LVOTO), high Model of end liver disease (MELD) scores, hyponatremia, and coagulopathies. The anesthesia management for liver transplantation can be very complex, dynamic and challenging. Anesthesia agents affect hepatic blood flow and anesthetic drug distribution, metabolism and elimination maybe altered in end stage liver disease...
January 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/25757167/-ischaemic-lesions-of-cerebral-after-carotid-stenting
#15
R B Medvedev, M M Tanashian, G I Kuntsevich, O V Lagoda, S I Skrylev, M V Krotenkova, A Iu Koshcheev, A S Suslin, É G Gemdzhian
Carotid angioplasty with stenting is a reliable method of primary and secondary prevention of ischaemic stroke in patients with stenosing lesions of the internal carotid artery. However, carrying out such operations is sometimes associated with risk for the development of intraoperative impairments of cerebral circulation due to arterioarterial embolism in cerebral arteries, as well as vasospasm. Presented herein are the results of following up a total of 64 patients with pronounced atherosclerotic lesions of internal carotid arteries (>70%) - "symptomatic" and "asymptomatic", undergoing carotid stenting...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/25612271/transcranial-doppler-guided-deairing-of-a-pediatric-ventricular-assist-device-experience-with-twins
#16
Gabor Erdoes, Alexander Kadner, Damian Hutter, Balthasar Eberle
We report the intraoperative courses of 2 consecutive Berlin Heart Excor® Pediatric Ventricular Assist Device implantations, in which transcranial Doppler ultrasonography helped to detect macroscopically undetected residual air bubbles captured in the pump after air removal had been correctly performed according to manufacturer's specifications. Our experience with these cases suggests that a beat-to beat deairing maneuver guided by transcranial Doppler is a useful strategy for reducing cerebral exposure to perioperative gaseous microembolism...
January 1, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/25509434/-prognostication-of-ischemic-complications-of-cerebral-vasospasm-in-surgical-treatment-of-intracranial-aneurysm-in-acute-period-of-its-rupture
#17
M V Hloba
With objective to create a model of prognostication of ischemic complications, occurred due to cerebral vasospasm (CVS), the informativeness of some clinic-instrumental indices was investigated in 350 patients in an acute period of intracranial arterial aneurysm rupture, using mathematical processing of the data. The terms from the disease beginning (3 - 14th day), severe state of patient while stay in hospital, localization of rupture in internal carotid artery, conduction of operation in terms up to 11 days after the rupture occurrence, presence of intraoperative complications, pronounced spasm of 3 and more segments of arteries preoperatively in accordance to angiography data, the pronounced and critical spasm postoperatively in accordance to ultrasonography data have had evolved as a prognostically significant causes in the CVS ischemic complications occurrence...
September 2014: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/25138929/-cerebral-blood-flow-monitoring
#18
REVIEW
Tomonobu Abe, Akihiko Usui
Cerebral ischemic events remain a major problem in patients undergoing cardiac and thoracic aortic surgery. Efforts to improve outcomes have been made in many aspects which include cerebral monitoring. New technology is making it possible to shed a light to the brain, which historically used to be a black box during general anesthesia in the operating room. Cerebral brain monitoring methods include cerebral oxymetry using near infrared spectroscopy, trans cranial Doppler, Jugular venous oxygen saturation, bispectral index, temporal artery pressure monitoring...
July 2014: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/24988966/-the-importance-of-transcranial-doppler-ultrasound-monitoring-for-prevention-of-intraoperative-cerebral-ischemia
#19
L B Novikova, G N Avertsev, A A Khamitov, N K Vasil'eva, A F Kuramshin, R Sh Abdurashitov, R I Ishbul'din, R M Galimov
OBJECTIVE: To determine the possibility of using transcranial ultrasound dopplerography (TCDG) in assessment of unfavorable changes in cerebral blood circulation which lead to the development of intraoperative cerebral ischemia. MATERIAL AND METHODS: We studied 55 patients who underwent vascular surgery or neurosurgical interventions. Changes in the systemic hemodynamics of ischemic character were recorded during the surgery in all patients. To assess the state of cerebral blood circulation, we performed TCDG using a special system of monitoring...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/24820395/cerebral-blood-flow-velocity-and-neurodevelopmental-outcome-in-infants-undergoing-surgery-for-congenital-heart-disease
#20
RANDOMIZED CONTROLLED TRIAL
Henry H Cheng, David Wypij, Peter C Laussen, David C Bellinger, Christian D Stopp, Janet S Soul, Jane W Newburger, Barry D Kussman
BACKGROUND: Cerebral blood flow velocity (CBFV) measured by transcranial Doppler sonography has provided information on cerebral perfusion in patients undergoing infant heart surgery, but no studies have reported a relationship to early postoperative and long-term neurodevelopmental outcomes. METHODS: CBFV was measured in infants undergoing biventricular repair without aortic arch reconstruction as part of a trial of hemodilution during cardiopulmonary bypass (CPB); CBFV (Vm, mean; Vs, systolic; Vd, end-diastolic) in the middle cerebral artery and change in Vm (rVm) were measured intraoperatively and up to 18 hours post-CPB...
July 2014: Annals of Thoracic Surgery
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