Transcranial Doppler findings during thoracic endovascular aortic repair Jean Bismuth, MD, Zsolt Garami, MD, Javier E. Anaya-Ayala, MD, Joseph J. Naoum,

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Transcranial Doppler findings during thoracic endovascular aortic repair Jean Bismuth, MD, Zsolt Garami, MD, Javier E. Anaya-Ayala, MD, Joseph J. Naoum, MD, Hosam F. El Sayed, MD, Eric K. Peden, MD, Alan B. Lumsden, MD, Mark G. Davies, MD, PhD, MBA Journal of Vascular Surgery Volume 54, Issue 2, Pages 364-369 (August 2011) DOI: 10.1016/j.jvs.2010.12.063 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Power M-mode Doppler (PMD) screen during transcranial monitoring. B, Spectra. Channel 1 indicates vessel label: Right middle cerebral artery (RMCA); channel 2, left MCA (LMCA; white box on the left side of the screen). Right side box: velocity and emboli counting parameters. The microembolic signals recorded on the PMD screen can be tracked as they move through the intracerebral circulation. Journal of Vascular Surgery 2011 54, 364-369DOI: (10.1016/j.jvs.2010.12.063) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 Transcranial Doppler screen: Bilateral middle cerebral artery (MCA) monitoring. Brightness changes at yellow arrow indicate contrast media arrival into both MCAs at the same time. Journal of Vascular Surgery 2011 54, 364-369DOI: (10.1016/j.jvs.2010.12.063) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 Number of patients per landing zone in this series. Journal of Vascular Surgery 2011 54, 364-369DOI: (10.1016/j.jvs.2010.12.063) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 4 Microembolic signals (MES) during the diagnostic phase (green bars) and treatment phase (blue bars). When the entire treatment phase (TP) was analyzed separately, devices deployed in landing zones 0 to 2 released more MES than those in landing zones 3 or 4 (P = .027). Journal of Vascular Surgery 2011 54, 364-369DOI: (10.1016/j.jvs.2010.12.063) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 5 Transcranial Doppler screen: Bilateral middle cerebral artery (MCA) monitoring during balloon in/deflation. Nine seconds of inflation/deflation shows waveform and velocity changes on both sides (white arrow: inflation starts, yellow: deflation starts, balloon was inflated for 6 seconds equals the time frame between the two arrows). Journal of Vascular Surgery 2011 54, 364-369DOI: (10.1016/j.jvs.2010.12.063) Copyright © 2011 Society for Vascular Surgery Terms and Conditions