Ultrasonic evaluation of the site of carotid axis occlusion in patients with acute cardioembolic stroke.

We performed the present study to determine whether the site of cardioembolic occlusion in the carotid axis could be identified by end-diastolic velocity measurements of the common carotid arteries.Using duplex carotid ultrasonography, we measured the flow velocity in the common carotid arteries and calculated the side-to-side ratios of the end-diastolic velocity (ED ratio; the end-diastolic velocity of the nonaffected side divided by that of the affected side) in 46 patients with acute cardioembolic stroke. The velocity on the faster side was divided by the slower velocity to obtain the normal values of ED ratio in 30 controls. The ED ratios were compared with the angiographic findings, in which unilateral intracranial internal carotid artery occlusion was present in 20 patients (IC group), occlusion of the horizontal segment of the middle cerebral artery was present in 16 patients (M1 group), and branch occlusion of the middle cerebral artery was present in 10 patients (MBr group). The ED ratios of the ...