| Patent foramen ovale and transcranial Doppler. Comparison of different procedures. | |
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MedLine Citation:
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PMID: 8969789 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The capability of transcranial Doppler sonography (TCD) to detect a patent foramen ovale (PFO) has been established. However, which provocative maneuver and what timing of contrast injection are most effective to induce a right-to-left shunt has not yet been determined. METHODS: We selected 38 cerebrovascular patients (21 men, 17 women) with positive contrast study for PFO on transesophageal echocardiography. Patients underwent a TCD with bilateral monitoring of the middle cerebral arteries (MCAs) and injection of a contrast solution. The injection was repeated (1) during normal breathing (basal conditions); (2) before Valsalva maneuver (VM); (3) during VM; (4) immediately after VM; and (5) during cough. The latency time and the total number of microbubbles for each side were recorded. RESULTS: TCD found positive results for PFO in 30 patients. Twenty were positive even during basal conditions. The number of positive cases varied according to the timing of the VM in relation to the contrast injection: 28, 25, and 27 cases were positive when the injection was performed before, during, and after VM, respectively, while 26 were positive during cough. There were significant differences in the number of microbubbles in the MCAs between the procedures (P < .001, ANOVA): the highest number was detected in the injection before VM and the lowest number during basal conditions (P < .001, Wilcoxon's test with Bonferroni's correction). The latency time was significantly shorter when the injection followed VM. CONCLUSIONS: The injection performed before VM appeared to be the most effective TCD procedure in determining the transit of microbubbles through a PFO and subsequently in the MCAs. |
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Authors:
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E M Zanette; G Mancini; S De Castro; M Solaro; D Cartoni; F Chiarotti |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 27 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1996 Dec |
Date Detail:
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Created Date: 1997-01-09 Completed Date: 1997-01-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2251-5 Citation Subset: IM |
Affiliation:
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Department of Neurological Sciences, University La Sapienza, Rome, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cerebral Arteries / ultrasonography* Contrast Media Echocardiography, Transesophageal* Female Heart Septal Defects, Atrial / complications, ultrasonography* Humans Intracranial Embolism and Thrombosis / etiology*, physiopathology Male Microtubules / ultrasonography Middle Aged Ultrasonography, Doppler, Transcranial* Valsalva Maneuver |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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