Journal for vascular ultrasound : JVU最新文献

{"title":"Clinical Risk Factors for Stroke and Associations with Microembolic Signals on Transcranial Doppler.","authors":"Abdullah A Adil, Carol C Mitchell, Thomas D Cook, Jenna Maybock, Nirvedh H Meshram, Tomy Varghese, Stephanie M Wilbrand, Robert J Dempsey","doi":"10.1177/15443167251347290","DOIUrl":"10.1177/15443167251347290","url":null,"abstract":"<p><strong>Introduction: </strong>Transcranial Doppler (TCD) has been used to identify microembolic signals (MES) in individuals with carotid atherosclerosis (CAS). MES are hypothesized to originate from unstable carotid plaque and have been identified in symptomatic and asymptomatic individuals with CAS. The purpose of this study is to examine the relationship of clinical risk factors for stroke (CRFs) and the presence of MES in patients with advanced CAS.</p><p><strong>Methods: </strong>Participants scheduled for carotid endarterectomy (CEA) (>60% stenosis NASCET and ACAS Criteria) were preoperatively evaluated for CRFs and the presence MES with TCD. Kendall's tau correlation coefficients, Pearson χ2, and logistic regression analysis were used to examine the relationship between MES and CRFs.</p><p><strong>Results: </strong>Participants (n=89) had a median (interquartile range) age of 71(13) years, 30 (33.7%) were female, and 53(59.6%) were symptomatic. MES were detected in 32 (36%) participants. There was significant evidence of association between MES with older age (p =0.026) and male sex (p =0.007). No other clinical variables showed significant association with MES (all p-values>0.05). Logistic regression demonstrated that a model including age(p=0.018), sex(p=0.013) and hyperlipidemia(p=0.083) was significantly associated with the presence of MES (p=0.001).</p><p><strong>Conclusion: </strong>MES were associated with older age and male sex in a cohort with advanced carotid atherosclerosis. Symptomatic status was not a predictor for MES in this cohort, suggesting that plaques in both symptomatic and asymptomatic individuals have the ability to release microemboli, highlighting the need for further work to be done to identify unstable plaques.</p>","PeriodicalId":73573,"journal":{"name":"Journal for vascular ultrasound : JVU","volume":"49 2","pages":"93-99"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial Color-Coded Doppler Cerebral Hemodynamics Following Aerobic Exercise Training: Outcomes From a Pilot Randomized Clinical Trial.","authors":"Carol Mitchell,&nbsp;J Max Gaitán,&nbsp;Ryan J Pewowaruk,&nbsp;Adam D Gepner,&nbsp;Timothy Hess,&nbsp;Stephanie M Wilbrand,&nbsp;Robert J Dempsey,&nbsp;Ryan J Dougherty,&nbsp;Dane B Cook,&nbsp;Ozioma Okonkwo","doi":"10.1177/15443167221099274","DOIUrl":"https://doi.org/10.1177/15443167221099274","url":null,"abstract":"<p><strong>Introduction: </strong>An active lifestyle with regular exercise is thought to decrease or delay the onset of Alzheimer dementia through increasing blood flow to the brain. We examined the mean flow velocity (MFV) and pulsatility index (PI) in the middle cerebral arteries of individuals randomized into two groups-a Usual Physical Activity (UPA) group and an Enhanced Physical Activity (EPA) exercise intervention group-to determine if exercise training is related to changes in cerebral blood flow.</p><p><strong>Methods: </strong>We examined 23 participants, randomized into a UPA group (n=12) and an EPA group (n=11), with transcranial color-coded Doppler (TCCD) and cardiorespiratory fitness (VO₂peak, mL/kg/min) testing at baseline and following a 26-week intervention. TCCD was used to measure MFV and PI. Participants in the EPA group completed supervised aerobic exercise training for 26 weeks. Kendall's tau b correlation was used to examine relationships between variables. The Wilcoxon Rank Sum tests were used to examine changes between the UPA and EPA groups.</p><p><strong>Results: </strong>There was no significant change in MFV or PI in the UPA group or the EPA group (p-values >0.05) between baseline and 26 weeks; the change between the UPA and EPA groups was also not significant (p=0.603). There was no evidence of an association between change in VO₂peak and change in MFV or PI (all p-values >0.05). Participants in the EPA group significantly increased their VO₂peak compared to the UPA group (p=0.027).</p><p><strong>Conclusion: </strong>This study did not demonstrate evidence of a significant change in the MFV in the middle cerebral arteries or evidence of a significant change in the PI between UPA and EPA groups. Future studies should be performed in larger cohorts and should consider use of personalized exercise programs to maximize understanding of how cerebrovascular hemodynamics change in structure and function with exercise for adults at risk for Alzheimer dementia.</p>","PeriodicalId":73573,"journal":{"name":"Journal for vascular ultrasound : JVU","volume":"46 3","pages":"110-117"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881430/pdf/nihms-1790301.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10518295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients.","authors":"Matteo Pozzi, Marco Giani, Benedetta Fumagalli, Mariangela Calabria, Davide Leni, Vittorio Segramora, Giacomo Bellani, Giuseppe Foti","doi":"10.1177/1544316720985812","DOIUrl":"10.1177/1544316720985812","url":null,"abstract":"<p><p>An increased risk of deep vein thrombosis (DVT) has been reported in critical COVID-19 patients, despite adequate thromboprophylaxis, and most of DVT are probably asymptomatic. As a screening approach has been advocated, the best examination protocol is unknown. The objective of this study is to assess the role of a Complete Duplex Ultrasound (CDUS) examination in detecting DVT in a large population of COVID-19 patients admitted to intensive care unit (ICU) for respiratory failure. Single-center retrospective study of 145 COVID-19 patients admitted to ICU. DVT was assessed with a CDUS performed by experienced radiologist after ICU admission. DVT was confirmed in 38 patients (26%). Most DVT were distal to the knee (66%), while only 16% were proximal. At the time of the examination, 55% of the patients received full-dose anticoagulation, while 45% received thromboprophylaxis, and there were no differences in anticoagulation regimen between positive and negative patients. Patients with DVT had higher dimers compared with those with negative CDUS (<i>P</i> < .002). The observed frequency of DVT is high despite adequate anticoagulation. A comprehensive and experienced ultrasound examination protocol can allow to recognize a large number of distal DVT otherwise missed, albeit their clinical significance is unknown.</p>","PeriodicalId":73573,"journal":{"name":"Journal for vascular ultrasound : JVU","volume":"45 1","pages":"11-14"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40325595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}