• Utilidad del doppler en la estenosis carotídea extracraneal

    El DTC puede detectar fiablemente los cambios hemodinámicos intracraneales secundarios a una estenosis significativa o una oclusión de la arteria carótida interna extracraneal (Wilterdink JL; 1997). Los hallazgos hemodinámicos principales incluyen: 1. flujo inverso (antidrómico) de baja resistencia de la arteria oftálmica ipsilateral a la lesión carotídea, 2. Flujo disminuido o ausente del sifón carotídeo ipsilateral, 3. Flujo atenuado y decelerado de la ACM ipsilateral, 4. Incremento de velocidades de la ACA contralateral 5. Apertura de la arteria Comunicante anterior, y 6. Presencia de flujo colateral (inversión de ACA ipsilateral, aceleración de ACP contralateral, etc) (Figuras 8 y 9) (Ver Figuras 8 y 9 jpg) . Para pacientes con diagnóstico angiográfico de una estenosis carotídea >70% la precisión diagnóstica del DTC para detectar los cambios hemodinámicos intracraneales es alta y dependerá de la experiencia del examinador para la interpretación de los hallazgos (Christou I et al; 2001).
     

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