Phillip J. Bendick, Ph.D., John L. Glover, M.D.

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Presentation transcript:

Vertebrobasilar insufficiency: Evaluation by quantitative duplex flow measurements Phillip J. Bendick, Ph.D., John L. Glover, M.D. Journal of Vascular Surgery Volume 5, Issue 4, Pages 594-600 (April 1987) DOI: 10.1016/0741-5214(87)90226-6 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Example of a normal vertebral artery spectrum with averaging to calculate time-averaged velocity (TAV). Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Measurement of the vertebral artery diameter corresponding to Fig. 1 used to calculate volumetric flow expressed in milliliters per minute. Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Quantitative vertebral artery flow data for individual vessels in patients with nonlocalizing symptoms of cerebral ischemia, comparing those patients with normal ipsilateral carotid arteries or only moderate disease (open bars) to those with significant lesions (greater than 50% stenosis) of the ipsilateral carotid artery (shaded bars). Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Right vertebral artery flow waveform in a patient with diminished net flow. Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Left vertebral artery flow waveform for patient in Fig. 4. Flow is diminished bilaterally but waveform shape is preserved, indicating the cause of insufficiency is probably not an atherosclerotic lesion. Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Arch arteriogram corresponding to Figs. 4 and 5 shows normal vertebral anatomy but generally poor cerebral perfusion (in this case caused by poor cardiac performance). Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 7 Significantly damped vertebral artery flow waveform with diastolic flow present but a severely diminished, rounded systolic peak characteristic of a proximal stenosis. Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 8 Arteriogram corresponding to Fig. 7 shows a severe stenosis at origin of the right vertebral artery. Journal of Vascular Surgery 1987 5, 594-600DOI: (10.1016/0741-5214(87)90226-6) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions