Right-to-left shunt detection sensitivity with air-saline and air-succinil gelatin transcranial Doppler

International Journal of Stroke : Official Journal of the International Stroke Society
Francesca PuleddaEdoardo Vicenzini

Abstract

Air-saline transcranial Doppler is nowadays the first-choice examination to identify right-to-left shunt. To increase right-to-left shunt detection in echocardiography, cardiologists also use air-gelatin mixtures, which are more stable, more echogenic, and easier to be prepared. We assessed the sensitivity of air-gelatin compared with air-saline for transcranial Doppler right-to-left shunt detection. Air-saline transcranial Doppler, during unilateral middle cerebral artery monitoring at rest and after Valsalva maneuver, was performed in patients referred to our neurosonology laboratory for right-to-left shunt detection. The same transcranial Doppler protocol was repeated with air-gelatin. To consider transcranial Doppler positive for cardiac right-to-left shunt, at least one embolic signal had to be detected within 20″ from contrast injection. Later signals were interpreted of pulmonary origin. Trans-thoracic echocardiography was repeated with both air-saline and air-gelatin. A total of 97 patients were enrolled; 46 had negative transcranial Doppler for cardiac right-to-left shunt with both air-saline and air-gelatin; out of these, four patients with air-saline plus two more patients with air-gelatin presented late, isolated mi...Continue Reading

References

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Apr 25, 2009·Cerebrovascular Diseases·Edoardo VicenziniGian Luigi Lenzi

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Citations

Apr 11, 2018·Stroke; a Journal of Cerebral Circulation·Brian H WestJonathan M Tobis

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