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Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy

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dc.contributor.authorKhan, Adnan
dc.contributor.authorSaqqur, Maher
dc.contributor.authorShuaib, Ashfaq
dc.contributor.authorKhan, Khurshid
dc.contributor.authorSharma, Vijay
dc.contributor.authorbrunser, alejandro
dc.contributor.authorEggers, Jürgen
dc.contributor.authorMikulik, Robert
dc.contributor.authorKatsanos, Aristeidis
dc.contributor.authorSergentanis, Theodore
dc.contributor.authorVadikolias, Konstantinos
dc.contributor.authorRubiera, Marta
dc.contributor.authorBavarsad, Reza
dc.contributor.authorThang, Huy
dc.contributor.authorMartínez, Patricia
dc.contributor.authorSafouris, Apostolos
dc.contributor.authorHeliopoulos, Ioannis
dc.contributor.authorSalam, Abdul
dc.contributor.authorDerksen, Carol
dc.contributor.authorVoumvourakis, Konstantinos
dc.contributor.authorPsaltopoulou, Theodora
dc.contributor.authorAlexandrov, Anne
dc.contributor.authorAlexandrov, Andrei
dc.contributor.authorTsivgoulis, Georgios
dc.contributor.authorCLOTBUST-PRO Investigators
dc.date.accessioned2025-01-30T15:10:18Z
dc.date.available2025-01-30T15:10:18Z
dc.date.issued2024
dc.description.abstractBackground and purpose: Transcranial Doppler (TCD) identifies acute stroke patients with arterial occlusion where treatment may not effectively open the blocked vessel. This study aimed to examine the clinical utility and prognostic value of TCD flow findings in patients enrolled in a multicenter prospective study (CLOTBUST-PRO). Methods: Patients enrolled with intracranial occlusion on computed tomography angiography (CTA) who underwent urgent TCD evaluation before intravenous thrombolysis was included in this analysis. TCD findings were assessed using the mean flow velocity (MFV) ratio, comparing the reciprocal ratios of the middle cerebral artery (MCA) depths bilaterally (affected MCA-to-contralateral MCA MFV [aMCA/cMCA MFV ratio]). Results: A total of 222 patients with intracranial occlusion on CTA were included in the study (mean age: 64 ± 14 years, 62% men). Eighty-eight patients had M1 MCA occlusions; baseline mean National Institutes of Health Stroke Scale (NIHSS) score was 16, and a 24-hour mean NIHSS score was 10 points. An aMCA/cMCA MFV ratio of <.6 had a sensitivity of 99%, specificity of 16%, positive predictive value (PV) of 60%, and negative PV of 94% for identifying large vessel occlusion (LVO) including M1 MCA, terminal internal carotid artery, or tandem ICA/MCA. Thrombolysis in Brain Ischemia scale, with (grade ≥1) compared to without flow (grade 0), showed a sensitivity of 17.1%, specificity of 86.9%, positive PV of 62%, and negative PV of 46% for identifying LVO. Conclusions: TCD is a valuable modality for evaluating arterial circulation in acute ischemic stroke patients, demonstrating significant potential as a screening tool for intravenous/intra-arterial lysis protocols.
dc.description.versionVersión Aceptada
dc.identifier.citationKhan A, Saqqur M, Shuaib A, Khan K, Sharma VK, Brunser A, Eggers J, Mikulik R, Katsanos AH, Sergentanis TN, Vadikolias K, Rubiera M, Shahripour RB, Nguyen HT, Martínez-Sánchez P, Safouris A, Heliopoulos I, Salam A, Derksen C, Voumvourakis K, Psaltopoulou T, Alexandrov AW, Alexandrov AV, Tsivgoulis G; CLOTBUST‐PRO Investigators. Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy. J Neuroimaging. 2024 Jul-Aug;34(4):430-437. doi: 10.1111/jon.13207
dc.identifier.doihttps://doi.org/10.1111/jon.13207
dc.identifier.urihttps://hdl.handle.net/11447/9750
dc.language.isoen
dc.subjectTIBI
dc.subjectmRS
dc.subjectReperfusion
dc.subjectStroke
dc.subjectTPA
dc.subjectThrombectomy
dc.subjectTranscranial Doppler
dc.titleValidation of the transcranial Doppler rescue criteria for mechanical thrombectomy
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceJournal of neuroimaging: official journal of the American Society of Neuroimaging
dspace.entity.typePublication
relation.isAuthorOfPublication80b7d5cb-f995-4261-af5a-e2e6d9539c21
relation.isAuthorOfPublication.latestForDiscovery80b7d5cb-f995-4261-af5a-e2e6d9539c21

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