Doppler pulse waveform analysis of carotid and middle cerebral artery flow in a patient with an intra-aortic balloon pump.

A 60-year-old man with intractable congestive heart failure (CHF) had an intra-aortic balloon pump placed to augment coronary artery perfusion. During the evaluation prior to heart transplant, carotid and transcranial Doppler ultrasonography (TCD) was performed. The authors report the findings of Doppler waveform analysis and the presence of balloon pump artifact which caused difficulty in distinguishing between internal and external carotid arteries. Higher blood flow velocity during diastole and diastolic runoff characteristically seen while insonating the internal carotid artery enabled that distinction.