Is inferior vena cava compression an alternative for valsalva maneuver in contrast-enhanced transcranial doppler？.

ABSTRACT

OBJECTIVES: To evaluate whether inferior vena cava compression (IVCC) can be an alternative for valsalva maneuver (VM) in contrast-enhanced transcranial doppler (c-TCD). METHODS: Patients diagnosed with ischemic stroke, transient ischemic attack, and migraine were enrolled in this study. C-TCD was conducted at resting state, after VM and IVCC to detect right to left shunt (RLS). Then, the RLS was compared to examine whether IVCC could be an alternative for VM in c-TCD. RESULTS: A total of 246 patients were enrolled in this study. Via Wilcoxon signed-rank test of paired data, the detection for RLS of c-TCD conducted after IVCC was superior to at resting state, but inferior to after VM (P ï¼œ .001, P = .01, respectively); the detection for RLS of c-TCD conducted after IVCC was inferior to after VM for patients with good cooperation of VM, but was superior for patients with poor cooperation of VM (P ï¼œ .001, P ï¼œ .001, respectively); the detection for RLS of c-TCD conducted after IVCC and after VM showed no significant difference for patients with good cooperation of VM and without abdominal obesity, or with poor cooperation of VM and with abdominal obesity (P = .201, P = .157, respectively); the detection for RLS of c-TCD conducted after IVCC was superior to at resting state for patients with abdominal obesity (P ï¼œ .001). CONCLUSIONS: For patients with poor cooperation of VM, IVCC could be used as an effective supplement to increase the detection of RLS in c-TCD.