The use of neurovascular ultrasound versus digital subtraction
                    angiography in acute ischemic stroke

Lange, Marcos C.; Bruch, Tatiana P.; Pedrozo, Jeff C.; Maranha, Luana; Sakae, Thiago Mamôru; Pacheco, Robertson; Souza, Paulo C.; Zétola, Viviane F.

doi:10.1590/0004-282X20140231

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ARTICLES • Arq. Neuro-Psiquiatr. 73 (3) • Mar 2015 • https://doi.org/10.1590/0004-282X20140231 linkcopy

The use of neurovascular ultrasound versus digital subtraction angiography in acute ischemic stroke

O uso do ultrassom neurovascular comparado a angiografia digital no AVC isquêmico agudo

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstracts

Cervical and intracranial arterial evaluation is an important issue for acute ischemic stroke (IS).

Objective Compare the use of the neurovascular ultrasound examination (NVUE) to digital subtraction angiography (DSA) in acute IS patients for diagnosing significant extracranial and intracranial arteriopathy.

Method Nonconsecutive patients with IS or transient ischemic attack admitted within 12 hours of the onset of symptoms were evaluated retrospectively. Standardized NVUE and DSA were done in all patients within the first 120 hours of hospital admission.

Results Twenty-four patients were included in the study. Compared to DSA, the NVUE demonstrated 94.7% sensitivity and 100% specificity for identifying symptomatic extracranial and/or intracranial arteriopathy.

Conclusion The standardized NVUE technique demonstrated high sensitivity and specificity compared to DSA for diagnosing arterial abnormalities in acute IS patients.

transcranial Doppler; ultrasonography; digital substraction angiography; ischemic stroke

Variable	N	%
Female	10	41.66
Mean age ± PD*	59.25 ± 14.47	-
Ischemic stroke	21	87.5
Transient ischemic attack	3	12.5
Stroke etiology
Large vessel	16	66.66
Cardioembolism	2	8.34
Small vessel	1	4.16
Undetermined	5	20.84
Stroke side
Left	13	54.16
Right	11	45.84
Stroke topography
Middle cerebral artery	21	87.5
Anterior cerebral artery	1	4.16
Posterior cerebral artery	1	4.16
Vertebrobasilar circulation	1	4.16
Stroke risk factors
Arterial hypertension	15	62.5
Diabetes mellitus	5	20.84
Hypercholesterolemia	4	16.66
Smoking habits	10	41.66
Thrombolytic therapy	8	33.33
Median NIHSS^† admission	7	-
Median NIHSS^† 24 hours	4	-
Median mRS^‡ 7 days	2	-
Median mRS^‡ 3 months	2	-

	Accuracy (%)	Sensitivity (%)	Specificity (%)	Positive Predictive Value (%)	Negative Predictive Value (%)
Symptomatic extracranial arteriopathy by CVD	100	100	100	100	100
Symptomatic intracranial arteriopathy by TCCS	99.6	85.7	100	100	99.6
Symptomatic extracranial and/or intracranial arteriopathy by NVUE	99.3	88.5	100	100	99.3

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[TFN1] N: Cases number; *PD: Pattern deviation; ^†NIHSS: National Institute of Health Stroke Scale; ^‡mRS: Modified Rankin Score.