Wall Shear Stress in the Feeding Native Conduit Arteries of Superficial Arteriovenous Malformations of the Lower Face is a Reliable Marker of Disease Progression.
Ultraschall Med
; 41(4): 428-438, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-30321881
ABSTRACT
PURPOSE:
To assess the prognostic value of the wall shear stress (WSS) measured in the feeding native arteries upstream from facial superficial arteriovenous malformations (sAVMs). Reliable prognostic criteria are needed to distinguish progressive from stable sAVMs and thus support the indication for an aggressive or a conservative management to avoid severe facial disfigurement. MATERIALS ANDMETHODS:
We prospectively included 25 patients with untreated facial sAVMs, 15 patients with surgically resected sAVMs and 15 controls. All had undergone Doppler ultrasound examination (DUS) with measurements of inner diameters, blood flow velocities, computation of blood flow and WSS of the feeding arteries. Based on the absence or presence of progression in clinical and imaging examinations 6 months after, we discriminated untreated patients as stable or progressive.RESULTS:
WSS in the ipsilateral external carotid artery was higher in progressive compared to stable sAVMs (15.8â±â3.3dynes/cm² vs. 9.6â±â2.0dynes/cm², mean±SD, pâ<â0.0001) with a cut-off of 11.5dynes/cm² (sensitivity 92â%, specificity 92â%, AUC 0.955, [95â%CI 0.789-0.998], pâ=â0.0001). WSS in the ipsilateral facial artery was also higher in progressive compared to stable sAVMs (50.7â±â14.5dynes/cm² vs. 25.2â±â7.1dynes/cm², pâ<â0.0001) with a cut-off of 34.0dynes/cm² (sensitivity 100â%, specificity 92â%, AUC 0.974, [95â%CI 0.819-1.000], pâ=â0.0001). The hemodynamic data of operated patients were not different from those of the control group.CONCLUSION:
WSS measured in the feeding arteries of an sAVM may be a simple reliable criterion to distinguish stable from progressive sAVMs. This value should be considered to guide the therapeutic strategy as well as the long-term follow-up of patients with facial sAVMs.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Malformações Arteriovenosas
/
Velocidade do Fluxo Sanguíneo
/
Face
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article