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T Rundek

Publications and source records attributed to T Rundek.

21 records · Page 2Linked to original sources

Duplex scanner versus conventional arteriography for carotid artery disease evaluation.

In order to evaluate extracranial circulation, Duplex scanning and conventional angiography were performed. The group of 41 patients (mean age 53.8 +/- 11.8, 71% male) were examined. Results were analyzed for extracranial disease presence such as presence of vessel stenosis (mild, moderate, severe), occlusion and presence of plaques. Data from Duplex scanning and carotid arteriography were correlated within the patients in the term of sensitivity and specificity of the methods used. The sensitivity of Duplex scanning for disease presence was 93% and specificity was 83%. For the presence of stenosis, sensitivity was 79% and specificity was 62%. For mild and moderate stenosis (less than 50% of lumen narrowing) sensitivity was 63%, whereas for severe, high-grade stenosis (greater than 50%) and occlusion the sensitivity was 100%. For the plaque presence the sensitivity was 52% and specificity was 73%. A good accordance of plaque findings with both methods was found only in 24% of patients. By Duplex scanner the plaques were discovered in 92% of patients while by arteriography they were found only in 32%. Duplex scanning and conventional arteriography are both accurate methods for determination of the reduction in diameter of carotid arteries (especially in stenosis greater than 50%), whereas Duplex scanning is more accurate for plaque detection and plaque characterisation.

Blood Flow Velocity↗

A correlation of 5-hydroxytriptamine and cerebral vasoreactivity in patients with migraine.

Cerebral haemodynamics and the level of serum 5-hydroxytriptamine (5-HT) were analysed in 21 migraine patients (8 with and 13 without aura) during the headache-free period as well as the attack. Cerebral vasoreactivity was evaluated by acetazolamide test and Transcranial Doppler ultrasonography (TCD). TCD findings were within normal ranges in the majority of migraine patients. Patients with migraine without aura had higher blood flow velocities (BFV) than patients with aura. Comparison of BVF and pulsatility index (PI) data patterns in migraine with and in migraine without aura during the attack revealed differences indicating cerebral hypoperfusion. It was noticed that systolic BFV decreased in migraine with aura on the headache side while PI increased. In migraine without aura, both systolic BFV and PI increased. 5-HT findings were heterogeneous. Reduction of cerebral vasoreactivity was observed especially in migraine with aura. Our results suggest different pathogenic mechanisms between migraine with and without aura, supporting the neurogenic inflammation theory.

Acetazolamide↗

[Importance of the evaluation of cerebral vasoreactive capacity in the indication for carotid endarterectomy].

In order to evaluate the outcome of endarterectomy, we estimated the cerebral vasoreactive capacity in 3 main patient groups with carotid artery disease: A. occlusion, B. high-grade, and C. low-grade carotid stenosis. The results showed that certain proportion of patients with reduced CVC can be distinguished in the each investigated groups, indicating thus, those patients in whom endarterectomy can benefit. Our study provides evidence that acetazolamide test with TCD measuring may be used to assess the CVC before and after endarterectomy. Carotid endarterectomy improves CVC in patients who had compromised cerebral perfusion reserve before operation. We suggest that the endarterectomy can also benefit in the patients with carotid occlusion and low grade stenosis if CVC is estimated.

Acetazolamide↗