Transcranial Doppler ultrasound as a guide to graded therapeutic occlusion of the carotid artery

C. A. Giller, P. Steig, H. H. Batjer, D. Samson, P. Purdy, A. D. Powers

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Although gradual carotid artery occlusion is an accepted and effective treatment for some surgically inaccessible intracranial aneurysms, there are no specific guidelines to determine the optimal amount of carotid artery narrowing at each adjustment. The technique of transcranial Doppler ultrasound, however, allows continuous measurement of blood velocity in the middle cerebral artery as the carotid artery is narrowed, so that hemodynamic effects and development of collateral flow can be immediately assessed at the bedside at each adjustment of the carotid artery diameter. This case report describes the use of transcranial Doppler to guide the rate of carotid occlusion in a patient with an unclippable giant aneurysm of the carotid artery. Sudden carotid occlusion and gradual occlusion at the usual rate were not tolerated by the patient, but repeatedly tightening the clamp until the first signs of attenuation of the Doppler signal allowed an expedient occlusion without complication. Transcranial Doppler ultrasound can provide a useful dynamic guide to gradual therapeutic carotid occlusion.

Original languageEnglish (US)
Pages (from-to)307-311
Number of pages5
Issue number2
StatePublished - 1990
Externally publishedYes


  • carotid artery occlusion
  • cerebral aneurysms
  • transcranial Doppler ultrasonography

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'Transcranial Doppler ultrasound as a guide to graded therapeutic occlusion of the carotid artery'. Together they form a unique fingerprint.

Cite this