Donate Help Contact The AHA Sign In Home
American Heart Association
Stroke
Search: search_blue_button Advanced Search
Published Online
on December 8, 2005

Stroke. 2005
Published online before print December 8, 2005, doi: 10.1161/01.STR.0000196988.45318.97
A more recent version of this article appeared on January 1, 2006
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
37/1/229    most recent
01.STR.0000196988.45318.97v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mikulik, R.
Right arrow Articles by Choi, J. Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mikulik, R.
Right arrow Articles by Choi, J. Y.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Ultrasound
Related Collections
Right arrow Carotid Stenosis
Right arrow Doppler ultrasound, Transcranial Doppler etc.

Submitted on May 13, 2005
Revised on October 19, 2005
Accepted on October 31, 2005

Telemedicine-Guided Carotid and Transcranial Ultrasound. A Pilot Feasibility Study

Robert Mikulik MD; Andrei V. Alexandrov MD; Marc Ribo MD; Zsolt Garami MD; Nichole A. Porche RN; Eva Fulep MD; James C. Grotta MD; Anne W. Wojner-Alexandrov PhD, FAAN; and John Y. Choi MD, MPH*

From the Department of Neurology (R.M., M.R., Z.G., N.A.P., E.F., J.C.G., J.Y.C.), University of Texas Health Science Center at Houston; Barrow Neurological Institute (A.V.A.), Phoenix, Ariz; Arizona State University, School of Nursing (A.W.W.-A.), Tempe, Ariz.

* To whom correspondence should be addressed. E-mail: John.Y.Choi{at}uth.tmc.edu.

Background and Purpose--Transcranial Doppler (TCD) and carotid duplex (CD) provide rapid and safe screening for stroke patients but are highly operator dependent. We explored the feasibility of telemedicine (TM)-guided TCD/CD administered by a health care provider inexperienced with ultrasound.

Methods--Dual video screens transmitted real-time TCD/CD images and sound to a neurosonographer. TM TCD/CD characteristics were compared with an in-person (IP) examination independently obtained on the same patient. We compared carotid stenosis, thrombolysis in brain ischemia (TIBI) flow grades, and the time spent on testing.

Results--We examined 8 subjects with a median age of 51 (31 to 63 range). IP and TM successfully examined 100% of internal carotid and middle cerebral arteries, 50% versus 44% of anterior cerebral artery, and 100% versus 88% of the basilar arteries, respectively. The median time in minutes IP versus TM was 15 (range 10 to 35) and 30 (15 to 50) for CD (P=0.07) and 18 (15 to 30) and 45 (30 to 55) for TCD (P=0.002), respectively. TM correctly identified all normal CD/TCD examinations in 7 subjects. In 1 patient, TM identified carotid occlusion but misread TIBI flow grades in both middle cerebral arteries.

Conclusions--Our pilot study showed the feasibility of TCD/CD by an inexperienced health professional guided by a sonographer via TM. Tests were completed within times comparable to outpatient setting in a vascular laboratory.
Key words: Doppler, transcranial • stroke • telemedicine • ultrasonography






Stroke Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search
Copyright © 2005 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.