Transcranial color-coded duplex sonography in suspected acute basilar artery occlusion

Area of Science:

• Neurology
• Vascular Imaging
• Diagnostic Ultrasound

Background:

• Transcranial color-coded duplex sonography (TCDS) is a standard noninvasive tool for assessing cerebral vascular abnormalities.
• The diagnostic utility of TCDS for acute basilar artery (BA) ischemia, particularly basilar artery occlusion (BAO), compared to CT angiography (CTA) and digital subtraction angiography (DSA), remains understudied.

Purpose of the Study:

• To prospectively evaluate the effectiveness of TCDS in diagnosing acute basilar artery occlusion (BAO).
• To assess the role of TCDS in the follow-up of patients with BAO.
• To compare TCDS findings with CTA and DSA for BAO diagnosis.

Main Methods:

• Prospective study of 15 consecutive patients with clinically suspected acute BAO.
• Initial diagnosis and assessment using TCDS.
• Follow-up TCDS examinations 3-5 days later for patients with confirmed BAO.

Main Results:

• Basilar artery ischemia was confirmed in 11 out of 15 patients.
• All patients diagnosed with BAO demonstrated recanalization of the basilar artery during follow-up.
• Recanalization occurred irrespective of whether thrombolytic therapy was administered.

Conclusions:

• TCDS is an efficient method for diagnosing BAO, especially when immediate angiography is unavailable.
• Combining TCDS with CTA enhances diagnostic accuracy and safety prior to invasive procedures like DSA.
• TCDS provides valuable information for monitoring BAO and assessing treatment response through recanalization assessment.