Abstract
Although pathology of the innominate artery (IA) is not frequent, it causes relevant impairment of extracranial circulation and sometimes cerebrovascular events. Definite differentiation of high-grade stenosis from occlusion of the IA has not been obtained until with (C.W.) Doppler and duplex system ultrasound, and thus the direct evaluation of IA is not reliable by noninvasive methods. In this study the authors suggest an indirect method, of evaluation of IA pathology based on the study of carotid, subclavian, and verte bral arteries (VA), with echo-Doppler-color-flow (EDCF) (with linear-phase ar ray, Probes of 7.5 and 5 MHz). In the last two years they studied 6 patients with, IA pathology, (2 with occlusion (occ), 1 with stenosis of 80% and 3 with subocclu sive stenosis >90%. In both patients with occ, right VA flow was inverted, and also the right common carotid (CC) was involved (occ in 1 case and inverted flow in the other ; in the 3 subocclusive stenoses a lowered systolic flow in the CC was recorded (48 vs 85cm/sec, 41 vs 77, and 23 vs 109). In the 80% stenosis, besides the inverted flow in VA, only a reduced diastolic flow in CC was also recorded (19 vs 33 cm/sec measured in the left side). All patients with high grade stenosis were successfufly confirmed by an angiographic study, including the different different degree of stenois.
Five of the 6 patients underwent surgical correction with a restored flow in the previously involve, artery. Only 1 patient with occlusion is waiting for surgi cal correction. In conclusion this study shows that ECDF can be a useful tool in the of IA pathology and in differentiation of occlusion from high grade stenosis by indirect signs in the supra-aortic circulation.
G.P. Signorini, M. D. Servizio di Angiologia Ospedale Civile di Padova Via Giustiniani 2 Padova 35128, Italy
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