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Detection of sub-critical arterial stenoses by hyperaemic Doppler

I C Currie1, Y G Wilson, R N Baird

  • 1Department of Vascular Surgery, Bristol Royal Infirmary, U.K.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|January 1, 1996
PubMed
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Hyperaemic Doppler ultrasound effectively detects sub-critical arterial stenoses at high flow rates. This method shows promise for identifying lesions without invasive pressure measurements, warranting further in vivo investigation.

Area of Science:

  • Vascular imaging and hemodynamics.
  • Medical device technology and fluid dynamics.

Background:

  • Accurate detection of sub-critical arterial stenoses is crucial for preventing cardiovascular events.
  • Current methods for stenosis assessment may involve invasive pressure measurements.
  • Non-invasive Doppler ultrasound offers a potential alternative for stenosis evaluation.

Purpose of the Study:

  • To evaluate the efficacy of hyperaemic Doppler ultrasound in detecting sub-critical arterial stenoses.
  • To compare Doppler-derived indices at varying flow rates using a flow rig model.

Main Methods:

  • A flow rig model simulating pulsatile blood flow was utilized.
  • Cadaver carotid arteries with variable, silk suture-induced stenoses were tested.
  • Pressure gradients and Doppler velocities (V1, V2) were recorded at low (200 ml/min) and high (400 ml/min) flow rates.

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  • Doppler indices (V2/V1 ratio, V2-V1 difference, modified Bernoulli) were calculated and correlated with pressure gradients (% delta P).

    • Main Results:

    • Correlation between Doppler indices and % delta P improved at high flow (r=0.87-0.88) versus low flow (r=0.81-0.84).
    • Sensitivity for detecting sub-critical stenoses increased from 82.8% at low flow to 96.6% at high flow.
    • The V2/V1 ratio demonstrated superior diagnostic performance compared to V2-V1 difference and Bernoulli indices.

    Conclusions:

    • The V2/V1 ratio is sensitive to hemodynamic changes at enhanced flow rates in arterial stenoses.
    • Hyperaemic Doppler ultrasound shows potential for detecting sub-critical lesions non-invasively.
    • Further in vivo studies are recommended to validate hyperaemic Doppler for clinical use.