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Transcranial color-coded duplex sonography in cerebral arteriovenous malformations
C Klötzch1, H Henkes, H C Nahser
1Department of Neurology, Alfreid-Krupp-Hospital, Essen, Germany.
Stroke
|December 1, 1995
Summary
Transcranial color-coded duplex sonography effectively monitors hemodynamic changes during cerebral arteriovenous malformation embolization. This noninvasive method aids in planning treatment by tracking blood flow velocity alterations in feeding arteries.
Area of Science:
- Neurology
- Vascular Surgery
- Medical Imaging
Background:
- Cerebral arteriovenous malformations (AVMs) can cause significant hemodynamic shifts during treatment, especially with hemorrhage or edema.
- Monitoring these hemodynamic changes is crucial for effective AVM management.
Purpose of the Study:
- To investigate blood flow velocity alterations during staged embolization of cerebral arteriovenous malformations.
- To assess the utility of transcranial color-coded duplex sonography (TCCD) in monitoring these hemodynamic changes.
Main Methods:
- Forty-one patients with cerebral AVMs were studied.
- TCCD was used to measure blood flow velocities in cerebral arteries before and after embolization procedures.
- Measurements were taken in 16 patients with supratentorial AVMs undergoing three to seven embolization treatments.
Main Results:
- TCCD successfully visualized AVMs and feeders in 71% of patients.
- Embolization led to a 23% reduction in peak flow velocity in treated feeders and a 12% increase in untreated feeders, indicating collateral flow.
- Reduced flow velocity (25%) was observed after treating feeders supplying cross-filling AVMs.
Conclusions:
- TCCD offers superior identification of feeding arteries compared to transcranial Doppler sonography.
- The technique allows for noninvasive, repeatable quantification of hemodynamic changes during staged embolization.
- TCCD is a valuable tool for planning and guiding embolization therapy for cerebral AVMs.