Abstract Details

Title Use of Pulsality Index for the Detection of Intracranial Arterial Stenosis Using Transcranial Doppler Ultrasonography

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 251

Objective

Background BACKGROUND: Gosling Pulsatility Index (PI) is a measure of the variability of blood velocity in a vessel, equal to the difference between the peak systolic and minimum diastolic velocities divided by the mean velocity during the cardiac cycle. Intracranial arterial stenosis is common in Asia.

Design/Methods DESIGN/METHODS: We measured the flow velocities and PI of the middle cerebral artery(MCA), internal carotid artery (ICA), and basilar artery (BA) in 346 stroke patients, using Power M Mode TCD machine (Spencer Technologies, USA). TCD recordings were correlated with CT or invasive angiographic findings. The mean, systolic and diastolic velocities were measured, and the Gosling PI was calculated automatically.All other major intracranial and extracranial cerebral arteries were also examined by TCD. The systolic and diastolic blood pressures, hematocrit, lipid profile, height and weight of the subjects were checked on the same day of TCD examination.

Results RESULTS: Mean age was 54.60 years (Range: 38-74) . There were 216 men and 130 women. Mean intracranial flow rates of > 160 cm/sec was associated with significant intracranial stenosis. Severe stenoses (reduction of the luminal area of the internal carotid artery by 70 % or more), reduced the PI) of the ipsilateral MCA. Mean PI was 0.68. For stenoses in the 75% to 89% category, PI (0.56-0.60)reduction was significantly greater in patients with bilateral carotid stenosis.

Conclusions CONCLUSIONS: PI is a useful indicator of cerebral hemodynamic asymmetry and a good Indicator of low Cerebral Perfusion Pressure. Low PI in severe carotid stenosis, indicates an impaired potential for collateral flow in these patients. PI is not a good descriptor of cerebrovascular resistance nor does it reliably predict raised intracranial pressure.

Authors/Disclosures
Mambakkam R. Sivakumar, MD (Genelab Biotechnologies Private Limited) PRESENTER	No disclosure on file
Sheila Oren, MD, MBA (Neuroderm)	Sheila Oren, MD, MBA has received personal compensation for serving as an employee of Neuroderm. Sheila Oren, MD, MBA has received personal compensation in the range of $0-$499 for serving as a Consultant for Neuroderm.

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