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Vol. 23, No. 5-6, 2007
Issue release date: May 2007
Section title: Original Paper
Cerebrovasc Dis 2007;23:424–429
(DOI:10.1159/000101466)

Is Transcranial Doppler for the Detection of Venous-to-Arterial Circulation Shunts Reproducible?

Sastry S. · Daly K. · Chengodu T. · McCollum C.
Department of Academic Surgery, South Manchester University Hospital, Manchester, UK

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/18/2006
Accepted: 12/4/2006
Published online: 4/2/2007

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background: We investigated the reproducibility of contrast transcranial Doppler (TCD), a safe non-invasive test for investigation of venous-to-arterial circulation shunts (v-aCS), usually patent foramen ovale, in young stroke patients. We also investigated whether microbubble contrast was reproducible and whether the addition of blood to agitated saline contrast affected the number of microbubbles produced. Methods: TCD investigation for v-aCS was repeated in 42 patients using a standardised protocol (i) by the same investigator and (ii) by a different investigator. Agitated saline was produced by mixing saline and 1 ml of air between two 10-ml syringes. The effect of adding blood and increasing the number of agitations was evaluated by microscopy examination using a haemocytometer to assess bubble numbers and sizes. Results: TCD: no difference was found in the highest microbubble count for the same investigator and between different investigators (p > 0.05). Reproducibility for the detection of v-aCS consistent with a patent foramen ovale was also good (ĸ values >0.8). Contrast: both the number of contrast mixes before injection and the presence of blood significantly increased the number of bubbles counted. On average, 18 agitations produced 1.86 (95% CI 1.62–2.13) times more bubbles than 6 agitations. Mixtures with blood produced on average 3.8 times more bubbles (3.08–4.69). The size of the bubbles was similar for all mixtures. Conclusions: Contrast TCD is reproducible and reliable for the detection of v-aCS. The addition of blood and 18 mixes rather than 6 significantly increased the number of microbubbles produced and may increase the effectiveness of microbubble contrast.


  

Author Contacts

Sanjay Sastry
Department of Academic Surgery
South Manchester University Hospital, Southmoor Road
Manchester M23 9PT (UK)
Tel. +44 161 291 5853, Fax 44 161 291 5854, E-Mail cnmcc@manchester.ac.uk

  

Article Information

Received: October 18, 2006
Accepted: December 4, 2006
Published online: April 2, 2007
Number of Print Pages : 6
Number of Figures : 3, Number of Tables : 2, Number of References : 19

  

Publication Details

Cerebrovascular Diseases

Vol. 23, No. 5-6, Year 2007 (Cover Date: May 2007)

Journal Editor: Hennerici, M.G. (Mannheim)
ISSN: 1015–9770 (print), 1421–9786 (Online)

For additional information: http://www.karger.com/CED


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/18/2006
Accepted: 12/4/2006
Published online: 4/2/2007

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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