Is transcranial Doppler a worthwhile examination for preoperative evaluation of the Circle of Willis? Evaluation of 137 carotid endarterectomies performed under regional anesthesia

摘要: Background Transcranial Doppler is often proposed for evaluation of the Circle Willis prior to carotid endarterectomy. The purpose this study was evaluate preoperative TCD before surgery. Methods This a retrospective report 137 endarterectomies performed under regional anesthesia operated between January 1992 on June 1996. All patients have tight stenosis 70% 99%, and 49% were symptomatic. Forty-three 132 had controlateral hemodynamically significant with none occlusion. examinations all ADMS Spectradop 3-MHz 2-MHz probes. Clinical during cross-clamping compared TCD. In 14% patients, could not be because there are temporal bone windows. Results When tested positive predictive value 18% sensitivity 33%. negative 94%. 8% shunted. numerous difficulties. most common lack window (40% patients). compression test difficult when lesion calcareous. Preoperative according our results, reliable enough examination modify operative strategy coupled arteriography it good way cerebral hemoynamics. Conclusions Regional local supplication remains method choice select those who require shunt It can used routinely less complex than various methods.