PMID- 34195898
OWN - NLM
STAT- MEDLINE
DCOM- 20220303
LR  - 20220621
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Linking)
VI  - 36
IP  - 1
DP  - 2022 Feb
TI  - Comparison Between Transcranial Color-Coded Duplex Doppler and Contrast Enhanced 
      Transcranial Color-Coded Duplex Doppler After Subarachnoid Aneurysmal Hemorrhage.
PG  - 82-88
LID - 10.1007/s12028-021-01255-8 [doi]
AB  - BACKGROUND: Transcranial color-coded duplex Doppler (TCCD) is commonly used to 
      detect and monitor vasospasm in subarachnoid aneurysmal hemorrhage (aSAH). 
      However, contrast enhanced TCCD (CE-TCCD) may be more effective. The objective of 
      this study was to compare the accuracy of TCCD and CE-TCCD in the detection of 
      vasospasm. METHODS: This study was a prospective comparison of TCCD and CE-TCCD 
      for the detection of vasospasm, using computed tomography angiography (CT 
      Angio) as a reference examination. The setting was the Department of 
      Anesthesiology and Intensive Care at the Bicetre University Hospital in Le 
      Kremlin Bicetre, France. TCCD and CE-TCCD were performed in 47 patients admitted 
      to the intensive care unit (ICU) following aSAH over a 7-month period. TCCD and 
      CE-TCCD were performed at ICU admission and between days 7 and 10. We aimed to 
      visualize the seven intracranial arteries of the circle of Willis. Vasospasm 
      diagnosis was assessed by CT Angio  and graded as moderate when the percentage 
      change in arterial diameter since admission was between 25 and 50% or as severe 
      when the percentage change was greater than 50%. RESULTS: On ICU admission, TCCD 
      allowed visualization of all intracranial arteries in 16 (34%) of 47 patients, 
      whereas CE-TCCD allowed visualization of all vessels in 37 (79%) of 47 patients 
      (p < 0.001). These results were consistent between days 7 and 10. The proportions 
      of middle cerebral arteries (MCAs), anterior cerebral arteries (ACAs) and 
      posterior cerebral arteries (PCAs) visualized were greater with CE-TCCD. There 
      was no difference in the visualization of basilar arteries (BAs). We performed 
      vasospasm analysis on 67 of 94 MCAs in 47 patients. Area under the curve (AUC) of 
      mean flow velocity to detect MCA vasospasm (moderate and severe) was 0.86 
      (0.58-1.00) for TCCD and 0.90 (0.77-1.00) for CE-TCCD. AUC of mean velocity to 
      detect severe MCA vasospasm was 0.86 (0.58-1.00) for TCCD and 0.90 (0.77-1.00) 
      for CE-TCCD, without any significant difference between the two techniques. For 
      other arteries, the accuracy of TCCD and CE-TCCD to diagnose vasospasm was poor. 
      CONCLUSIONS: CE-TCCD allows better visualization of intracranial arteries in 
      patients with aSAH. The accuracy of CE-TCCD to screen severe MCA vasospasm is 
      similar to that of TCCD. CE-TCCD is an alternative tool for monitoring patients 
      with aSAH without a temporal bone window for an ultrasound.
CI  - (c) 2021. Springer Science+Business Media, LLC, part of Springer Nature and 
      Neurocritical Care Society.
FAU - Rodrigues, Aurore
AU  - Rodrigues A
AUID- ORCID: 0000-0002-3360-0294
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France. aurore.rodrigues@aphp.fr.
FAU - Tarazona, Virginie
AU  - Tarazona V
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
FAU - Ladoux, Alexandre
AU  - Ladoux A
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
FAU - Leblanc, Pierre Etienne
AU  - Leblanc PE
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
FAU - Harrois, Anatole
AU  - Harrois A
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
FAU - Vigue, Bernard
AU  - Vigue B
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
FAU - Duranteau, Jacques
AU  - Duranteau J
AD  - Department of Anesthesiology and Critical Care, Hopitaux Universitaires Paris 
      Saclay, Universite Paris Saclay, Assistance Publique-Hopitaux de Paris, Le 
      Kremlin-Bicetre, France.
LA  - eng
PT  - Journal Article
DEP - 20210630
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
SB  - IM
MH  - Humans
MH  - Middle Cerebral Artery
MH  - Prospective Studies
MH  - *Subarachnoid Hemorrhage/complications/diagnostic imaging
MH  - Tomography, X-Ray Computed
MH  - Ultrasonography, Doppler, Transcranial/methods
MH  - *Vasospasm, Intracranial/diagnostic imaging/etiology
OTO - NOTNLM
OT  - Aneurysmal subarachnoid hemorrhage
OT  - Cerebral vasospasm
OT  - Neurocritical care
OT  - Transcranial Doppler
EDAT- 2021/07/02 06:00
MHDA- 2022/03/04 06:00
CRDT- 2021/07/01 07:18
PHST- 2020/12/05 00:00 [received]
PHST- 2021/04/10 00:00 [accepted]
PHST- 2021/07/02 06:00 [pubmed]
PHST- 2022/03/04 06:00 [medline]
PHST- 2021/07/01 07:18 [entrez]
AID - 10.1007/s12028-021-01255-8 [pii]
AID - 10.1007/s12028-021-01255-8 [doi]
PST - ppublish
SO  - Neurocrit Care. 2022 Feb;36(1):82-88. doi: 10.1007/s12028-021-01255-8. Epub 2021 
      Jun 30.