Coventry and Warwickshire County Vascular Unit, Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.
Ultrasound Med Biol. 2011 May;37(5):719-22. doi: 10.1016/j.ultrasmedbio.2011.01.018. Epub 2011 Mar 31.
Transcranial Doppler has been used to identify microembolic signals before, during and after carotid endarterectomy, but 10% to 15% of patients are reported not to have suitable temporal bone window. The aim of this study was to assess the feasibility of transorbital Doppler monitoring of patients with absent temporal bone acoustic window. Between 2005 and 2008, those patients with absent temporal bone acoustic window were assessed for a transorbital acoustic window. During the study period, 318 carotid endarterectomy were performed. In the 29 (9.1%) with absent temporal bone acoustic window, 25 (86%) had satisfactory transorbital acoustic windows, consequently only four (1.2%) of patients could not be monitored postoperatively. One patient required postoperative transorbital acoustic windows directed glycoprotein IIb/IIIa receptor antagonist infusion due to excessive carotid microembolisation to prevent stroke. This is the first description of the use of transorbital flow imaging to determine postoperative cerebral blood flow, microembolic load and to direct the use of intravenous antiplatelet agents.
经颅多普勒已被用于在颈动脉内膜切除术之前、期间和之后识别微栓塞信号，但据报道，有 10%至 15%的患者不具备合适的颞骨窗。本研究旨在评估经眶多普勒监测无颞骨声窗患者的可行性。在 2005 年至 2008 年间，对那些无颞骨声窗的患者进行了经眶声窗评估。在研究期间，进行了 318 例颈动脉内膜切除术。在 29 例（9.1%）无颞骨声窗的患者中，25 例（86%）有满意的经眶声窗，因此只有 4 例（1.2%）患者术后无法监测。由于颈动脉微栓塞过多导致卒中，一名患者需要术后经眶声窗定向给予糖蛋白 IIb/IIIa 受体拮抗剂输注，以预防卒中。这是首次描述使用经眶血流成像来确定术后脑血流、微栓塞负荷，并指导静脉内抗血小板药物的使用。
