Possibilities of ultrasound examination of the cerebral blood flow in patients with acute ischemic stroke treated by various types of reperfusion therapy

Abstract

Relevance. Acute ischemic stroke (AIS) is associated with a high level of mortality, disability and, therefore, corresponding economic costs. The effectiveness of treatment is directly dependent on the duration of the “therapeutic window”. Therefore, for the fastest diagnosis, dynamic control, timely adoption of tactical decisions and prediction of treatment results, an accessible, objective and reproducible diagnostic method is required. Purpose. To determine the possibilities of duplex ultrasound of extra- and intracranial arteries at the early stages of AIS treatment. Methods. The study included 460 patients with AIS before and after using various reperfusion methods: systemic thrombolytic therapy, thrombextraction, stenting, and its combinations. Clinical-radiological comparisons were made using clinical scales and radiological methods: computed tomography, computed angiography and radioangiography. Results. The study confirmed comparability of the results of vascular intracranial ultrasound with the data of angiography. The relationship between the presence and degree of stenoocclusive lesions of extracranial arteries and the functional and clinical outcome has been established. Hemodynamics in the intracranial arteries at the early stages after treatment were characterized by hyperperfusion, correlated with a favorable clinical outcome. Conclusion. Cerebral ultrasound in patients with AIS can serve as the method of choice for non-invasive primary diagnosis and monitoring the effectiveness of revascularization and predicting outcomes.