TRANSCRANIAL DOPPLER SONOGRAPHIC MONITORING DURING PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY OF THE INTERNAL CAROTID-ARTERY

Our purpose was to assess the haemodynamic changes in the ipsilateral middle cerebral artery (MCA) during and after percutaneous translumina l angioplasty (PTA) of the internal carotid artery (ICA), and to compa re them with clinical and angiographic findings, Transcranial Doppler Sonographic monitoring (TCD) of the MCA was performed during PTA in 22 patients with symptomatic severe stenosis of the ICA. Mean blood flow velocity (MBFV) and pulsatility index (PI) were recorded. During PTA, MBFV fell from 41 +/- 15 cm/s to 23 +/- 11 cm/s (P = 0.0001), Changes in PI were inconsistent. With reduction of MBFV of 50 % or less (in 1 0 cases) no complication occurred, With a reduction of more than 50 % (in 12), 6 patients developed neurological disturbances (transient isc haemic attacks in 5 and minor stroke in 1), This difference was signif icant (P = 0.0152), Symptomatic patients also had a higher rate of str oke prior to PTA (4/6) than patients who remained asymptomatic during PTA (0/6). After PTA had been performed MBFV and PI improved significa ntly (P = 0.0001), MBFV increasing to 48 +/- 16 cm/s and PI from 0.64 +/- 0.11 to 0.86 +/- 0.15. TCD changes proved more sensitive to cerebr al haemodynamics than angiography in 8 patients.