Transcranial Doppler as a Predictor of Ischemic Events in Vertebral Artery Dissection

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dc.contributor.authorBrunser, Alejandro
dc.contributor.authorLavados, Pablo
dc.contributor.authorCavada, Gabriel
dc.contributor.authorMuñoz Venturelli, Paula
dc.contributor.authorOlavarría, Verónica
dc.contributor.authorNavia, Víctor
dc.contributor.authorMansilla, Eloy
dc.contributor.authorDíaz, Violeta
dc.date.accessioned2021-08-05T20:32:40Z
dc.date.available2021-08-05T20:32:40Z
dc.date.issued2020
dc.description.abstractBackground and purpose: Transcranial Doppler (TCD) helps identify patients with carotid dissections at risk of ischemic events (IEs). There is paucity of data identifying independent predictors of IE in vertebral arterial dissection (VAD). We sought to investigate the clinical and ultrasound predictors of IE. Methods: Patients with VAD admitted between June 2017 and February 2020 were evaluated clinically and with TCD; sonographic curves, microembolic signals (MES), and the breath-holding index (BHI) test were applied. Covariates found on univariate screen (P < .25) were included in a multivariable linear regression to identify independent predictors of IEs. Results: Of 88 patients with 100 VAD, 75 (85.2%) were females with a mean age 37.9 ± 7.5 years. All patients received antiplatelet treatment. TCD monitoring lasted an average of 21 ± 2.1 minutes. TCD was abnormal in 23 cases (26.1%); 21 patients had abnormal sonographic curves in the vertebral/basilar arteries, while in 4 cases, MES were present and in 5 (4.5%), BHI was abnormal. None of the patients with a normal TCD had an IE. Six strokes occurred during follow up. On univariate analysis, male sex, diabetes, dyslipidemia, a previous myocardial infarct, migraine, time of consultation to the ER, bilateral VAD, MES, BHI abnormalities, post stenotic flow in the basilar artery (PFB), and basilar/vertebral velocities were significantly associated with the risk of IEs. In the multivariate analysis, only the presence of PFB was a significant predictor of IE (OR: 68.6, 95% CI 5-937, <.001). Conclusions: TCD in VAD predicts patients at high risk of IE.es
dc.description.versionVersión Publicada
dc.identifier.citationBrunser AM, Lavados PM, Cavada G, Muñoz-Venturelli P, Olavarría VV, Navia V, Mansilla E, Díaz V. Transcranial Doppler as a Predictor of Ischemic Events in Vertebral Artery Dissection. J Neuroimaging. 2020 Nov;30(6):890-895. doi: 10.1111/jon.12773.es
dc.identifier.urihttps://doi.org/10.1111/jon.12773es
dc.identifier.urihttp://hdl.handle.net/11447/4241
dc.language.isoenes
dc.sourceJournal of Neuroimaging
dc.subjectUltrasoundes
dc.subjectCervical artery dissectiones
dc.subjectStrokees
dc.subjectTranscranial Doppler ultrasoundes
dc.titleTranscranial Doppler as a Predictor of Ischemic Events in Vertebral Artery Dissectiones
dc.typeArticlees

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