Echo-enhanced transcranial color-coded duplexsonography to study collateral blood flow in patients with symptomatic obstructions of the internal carotid artery and limited acoustic bone windows

We prospectively evaluated 30 consecutive patients with echo-enhanced trans cranial color-coded duplexsonography (TCCD) and correlative transfemoral di gital subtraction angiography to assess the diagnostic efficacy of echo-enh anced TCCD for evaluation of collateral pathways through the circle of Will is in patients with limited acoustic bone windows and critical symptomatic carotid disease. Echo-enhanced TCCD detected collateral blood flow through the anterior communicating artery in 16 of 18 patients (sensitivity 89%, 95 % CI 65-99%) and was false positive in one out of 12 patients without colla teral flow (specificity 92%, 95% CI 59-100%). For the posterior communicati ng artery, sensitivity was 11/14 (79%, 95% CI 49-95%) and specificity was 1 5/16 (94%, 95% CI 70-100%). Echo-enhanced TCCD enables to study collateral blood flow through the communicating arteries of the circle of Willis with high sensitivity and specificity in patients with obstructions of the inter nal carotid artery and limited acoustic bone windows. Copyright (C) 2001 S. Karger AG, Basel.