THE VALUE OF TRANSCRANIAL DOPPLER ULTRASONOGRAPHY IN ASSESSING RECANALIZATION OUTCOMES IN ACUTE STROKE PATIENTS AT MILITARY HOSPITAL 175
DOI:
https://doi.org/10.59354/ydth175.2026.451Keywords:
Acute ischemic stroke, Transcranial Doppler (TCD), Mechanical thrombectomy, Recanalization, Intracranial restenosisAbstract
Objectives: To describe transcranial Doppler (TCD) imaging features of intracranial arteries in acute stroke patients following recanalization therapy and to evaluate the diagnostic accuracy (sensitivity, specificity, and predictive values) of TCD in detecting intracranial arterial restenosis.
Materials and Methods: A prospective cross-sectional study was conducted at the Department of Neurology, Military Hospital 175, from November 2023 to April 2025. The study included acute ischemic stroke patients who underwent mechanical thrombectomy within 24 hours of symptom onset or last known well time.
Results: We enrolled 179 patients with acute ischemic stroke who underwent reperfusion therapy, with a male-to-female ratio of approximately 1.8:1 (64.2% male and 35.8% female). The mean age of the study population was approximately 65 years, and female patients were significantly older than male patients (69 vs. 63 years, p < 0.01). Regarding medical history and vascular risk factors, hypertension was the most common risk factor, present in 60% of patients, followed by diabetes mellitus in 25% and dyslipidemia in 4.5%. The diagnostic performance of TCD compared with MRA in the overall sample showed a sensitivity of 99.1%, specificity of 70.4%, positive predictive value of 83.6%, negative predictive value of 98.0%, and a kappa coefficient of 0.73. In the anterior circulation, the corresponding values were 100%, 71.4%, 84.5%, 100%, and 0.75, respectively, whereas in the posterior circulation, they were 95.2%, 66.7%, 80.0%, 90.9%, and 0.64, respectively.
Conclusion: TCD is recommended as a first-line screening and routine follow-up modality post-intervention due to its high sensitivity, safety profile, and cost-effectiveness. Confirmatory imaging with MRA or CTA is indicated when TCD findings are positive, clinical status deteriorates, or flow velocity changes are detected at the intervention site.
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