Echocolordoppler TSA and CT
When is this exam indicated?
Echocolordoppler of the supra-aortic arterial trunks is requested to assess the presence or absence of wall changes or plaques related to aging or a vessel disease termed "atherosclerosis". It is also able to identify other arterial vessel pathologies, such as vessel wall dissection.
Atherosclerosis is a disease characterized initially by wall thickening and then by actual plaques ("atheromas") of the arteries, which are formed by the accumulation of cholesterol, inflammatory cells and fibrotic material, sometimes with calcium deposition. The origin of atherosclerosis is multifactorial, in part due to genetic predisposition, in part due to environmental factors, such as high blood pressure, diabetes mellitus, high blood cholesterol levels, overweight, cigarette smoking, sedentary lifestyle, etc.
Atherosclerosis of the supra-aortic trunks can cause strokes, memory and other cognitive impairments up to dementia, and posture and gait disturbances up to vascular parkinsonism. Therefore, the echocolordoppler of the supra-aortic arterial trunks is a test that allows to identify and prevent the so-called "vascular encephalopathy", acute or chronic, that is the suffering of the brain or other parts of the brain due to the closure (acute or progressive) of arterial vessels. Early detection of atherosclerosis in the carotid artery allows for treatments to reduce the risk of stroke, cognitive impairment, and Parkinsonism.
It is also important to remember that atherosclerosis is a systemic disease, affecting arterial vessels of various body areas (including heart and coronary arteries, aorta and lower limbs, in addition to supra-aortic trunks). Therefore, the study of the arterial vessels of the neck, easily performed by echocolordoppler of the supra-aortic trunks, also allows to establish the risk of involvement in other body areas by atherosclerosis. Early diagnosis allows the use of preventive therapies (of stroke, heart attack, etc.), increasingly important with the increase in the average life of the population and, therefore, the incidence of these diseases.
The transcranial Doppler, combined with the use of "microbubbles" of saline solution, allows to verify if there are shunts between venous and arterial vessels of our body, or direct connections that bypass the pulmonary filter. These shunts are often associated with the presence of a frequent congenital anomaly, the so-called "pervious foramen ovale". Transcranial Doppler-detected shunts with microbubbles (and pervious foramen ovale) have been associated with a fair proportion of strokes, especially at younger ages, and also in persons without conventional risk factors for stroke.
How is it performed?
It is an ultrasound of the neck with a particular method that allows the study of wall and the study of blood flows in the vessels. The duration of the examination is approximately 15-20 minutes, except for some special situations that require longer times.
There are no contraindications. The examination is completely non-invasive. As already explained, it is an operator-dependent examination, therefore the quality of the report strongly depends on the experience of the physician and on the machines used.