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[Flow reversal in the carotid bifurcation. Detection using color-coded Doppler sonography]
S Trattnig1, B Schwaighofer, F Kainberger
1Abteilung für diagnostische Radiologie, II. Medizinische Universitätsklinik, Wien.
Der Radiologe
|November 1, 1990
Summary
Flow reversal in the carotid sinus indicates normal bifurcation. Its absence suggests atherosclerosis, a finding supported by Doppler sonography in 156 patients. This helps diagnose carotid artery disease.
Area of Science:
- Vascular Ultrasound
- Hemodynamics
- Cardiovascular Imaging
Background:
- Normal carotid sinus blood flow has laminar antegrade flow and a posterolateral boundary layer with transient flow reversal.
- This flow reversal, previously observed in vitro, can now be documented using color-coded Doppler sonography.
Purpose of the Study:
- To investigate the hypothesis that flow separation, indicated by flow reversal, is a marker of a normal carotid bifurcation.
- To determine if the loss of flow reversal is indicative of atherosclerosis in the carotid bifurcation.
Main Methods:
- Retrospective study of 156 patients (312 arteries) examining carotid sinus flow patterns using color-coded Doppler sonography.
- Analysis of flow reversal presence or absence in relation to carotid bifurcation morphology and presence of atheromatous lesions.
Main Results:
- Flow reversal was absent in 4 patients without atheromatous lesions but also lacking bulb formation.
- Flow reversal was present in various pathological conditions, including plaque formation, internal carotid artery occlusion, common carotid artery occlusion, and post-disocclusion pseudobulb formation.
Conclusions:
- The presence of flow reversal in the carotid sinus is indicative of normal bifurcation anatomy.
- The absence of flow reversal, particularly in the absence of bulb formation, suggests potential atherosclerosis or other pathological changes within the carotid bifurcation.