Ascertaining the value of noninvasive measures obtained using color duplex ultrasound and central aortic pressure monitoring during the management of cerebral arteriovenous malformation resection: protocol for a prospective, case control pilot study

Kathryn J. Busch*, Hosen Kiat

*Corresponding author for this work

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Abstract

Background: Dramatic hemodynamic changes occur upon removal of an arteriovenous malformation of the brain (bAVM) with a number of potentially serious perioperative complications, such as intracranial hemorrhage and venous occlusive hypertensive syndrome. As these complications largely occur in the postoperative inpatient period, a rapid, repeatable noninvasive investigation to serially monitor relevant intracranial hemodynamics may be of benefit. Though, transcranial Doppler (TCD) and transcranial color duplex (TCCD) are techniques used and available to provide hemodynamic measurements postoperatively, the time course of hemodynamic sequences following bAVM resection remains uncertain. Objective: This is a prospective, case control pilot study conducted in participants having elective bAVM resection surgery. Methods: Each participant will undergo a preoperative color duplex ultrasound (CDU) of the bilateral extracranial carotid arteries, a CDU of the circle of Willis including the bAVM vessels, and a central aortic pressure measurement, repeated daily, postoperatively, for a 2-week period. Results: Patient accrual has commenced with anticipation of first results in 2018. Conclusions: This protocol aims to strengthen the work of previous authors by providing documentation of the time course of hemodynamic changes following bAVM resection. The protocol is designed to determine whether noninvasive technology, including CDU imaging of the extracranial carotid and intracranial arteries in the form of TCCD along with central aortic pressure measurements, can determine whether there are any hemodynamically significant prognostic markers that may provide insight into the process of vessel remodeling, including insight into venous changes following bAVM resection.

Original languageEnglish
Article numbere173
Number of pages6
JournalJMIR Research Protocols
Volume6
Issue number8
DOIs
Publication statusPublished - Aug 2017

Bibliographical note

Copyright the Author(s). Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • brian
  • transcranial
  • arteriovenous malformation
  • color duplex
  • hemodynamics
  • pressure

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