Should TCDs be routinely used for evaluating intracranial circulation for screening high risk patients prior to cardiac surgery? (P2.280)

CONCLUSIONS: Our case elucidates the possibility of a hypoperfusion stroke related to left vertebral dominantly supplying intracranial circulation in presence of bilateral significant carotid stenosis. Due to lack of previous cardio/cerebrovascular events, his carotid stenosis was deemed asymptomatic prior to cardiac surgery. We propose that intracranial collateral flow should be investigated via TCD in patients with bilateral carotid stenosis undergoing procedures with high stroke risk to assess safety and efficacy of carotid revascularization in this small but significant subset. Additional studies like acetazolamide with TCDs may be useful to select appropriate patients who will benefit from carotid revascularization.Disclosure: Dr. Vu has nothing to disclose. Dr. Bishop has nothing to disclose. Dr. Edwards has nothing to disclose. Dr. Tegeler has nothing to disclose. Dr. Sarwal has nothing to disclose.

Source: Neurology - April 8, 2015 Category: Neurology Authors: Vu, Q., Bishop, L., Edwards, M., Tegeler, C., Sarwal, A. Tags: Cerebrovascular Disease and Interventional Neurology: PFO and Other Cardiac Disease Source Type: research