Rautenberg W, Hennerici M
Department of Neurology, University of Düsseldorf, Federal Republic of Germany.
Stroke. 1988 Dec;19(12):1514-20. doi: 10.1161/01.str.19.12.1514.
In 14 patients with severe stenosis or occlusion of the innominate artery a new high-energy, low-frequency (2 MHz) pulsed Doppler ultrasound method was used to investigate blood flow velocity patterns of both intrathoracic and intracranial cerebral arteries. Direct acquisition and evaluation of the innominate artery at its origin near the aortic arch enabled separation of it from adjacent arteries and reliable differentiation of stenosis from occlusion. Transcranial recordings from the basal cerebral arteries showed abnormal Doppler signals in 12 patients (86%). Among these abnormalities, observation of a latent steal phenomenon was closely related to the prevalence of cerebrovascular events. This latent steal phenomenon was characterized by a transient reduction of orthograde blood flow in the ipsilateral anterior, middle, and posterior cerebral arteries or in the basilar artery during postischemic hyperemia of the upper extremities. The predictive value of the latent steal phenomenon for the management and follow-up of asymptomatic patients with severe innominate artery obstructions is discussed.
在14例无名动脉严重狭窄或闭塞患者中，采用一种新的高能、低频（2兆赫）脉冲多普勒超声方法，研究胸内和颅内脑动脉的血流速度模式。在主动脉弓附近无名动脉起始处直接采集和评估，能够将其与相邻动脉区分开，并可靠地区分狭窄与闭塞。对基底脑动脉进行经颅记录显示，12例患者（86%）出现异常多普勒信号。在这些异常情况中，潜在盗血现象的观察与脑血管事件的发生率密切相关。这种潜在盗血现象的特征是，在上肢缺血后充血期间，同侧大脑前、中、后动脉或基底动脉的正向血流短暂减少。本文讨论了潜在盗血现象对无症状严重无名动脉阻塞患者管理和随访的预测价值。
