Usefulness of intravascular Doppler flow measurements in cerebral endovascular treatment. A comparison with trans cranial Doppler.

SUMMARY: Measurement of cerebral blood flow in cerebral endovascular procedures is useful for the assessment of treatment effects. We used transcranial Doppler sonography (TCD) and Doppler guide wires (SmartWire((R)), Cardiometries Co.) in intravascular treatment. The cases were 6 brain arteriovenous malformations (AVM), 2 carotid cavernous fistulas (CCF), 2 facial angiomas, and 2 carotid stenoses. Intravascular cerebral blood flow measurements with the SmartWire were performed during the endovascular procedure. TCD was used pre- and post-endovascular treatment, and velocity, pulsatility index (PI) and resistance index (RI) were compared with the SmartWire. For both TCD and Smart Wire, blood velocity of the main artery decreased, and PI and RI were improved after embolisation of AVM. In angioplasty cases, post stenotic flow velocity, as measured by SmartWire, was improved, and the flow of MCA measured with TCD was also improved after treatment. The SmartWire is useful to assess cerebral blood flow changes during the neuroendovascular procedure. Combined with repeated follow up with TCD, Doppler flow measurements are useful to assess the effect of endovascular treatment.