Key result
Doppler ultrasound during IABP support shows artifacts but higher diastolic flow distinguishes the internal carotid.
Why the study?
Doppler waveform analysis in patients with intra-aortic balloon pump support can be challenging due to balloon pump artifacts affecting artery distinction.
Case Report (n=1)
In patients with an intra-aortic balloon pump, balloon pump artifact can complicate carotid Doppler interpretation, but diastolic flow characteristics can still distinguish the internal from external carotid artery.
Answers are grounded in this paper and cite their sources.
Clinicians should interpret carotid Doppler cautiously with IABP; this single case leaves open whether diastolic velocity reliably distinguishes the ICA.
A 60-year-old man with intractable congestive heart failure (CHF) had an intra-aortic balloon pump placed to augment coronary artery perfusion. During the evaluation prior to heart transplant, carotid and transcranial Doppler ultrasonography (TCD) was performed. The authors report the findings of Doppler waveform analysis and the presence of balloon pump artifact which caused difficulty in distinguishing between internal and external carotid arteries. Higher blood flow velocity during diastole and diastolic runoff characteristically seen while insonating the internal carotid artery enabled that distinction.
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Ober et al. (1999) conducted a case report in Intractable congestive heart failure (CHF) (n=1). Carotid and transcranial Doppler ultrasonography was evaluated on Findings of Doppler waveform analysis and presence of balloon pump artifact. Carotid and transcranial Doppler ultrasonography in a patient with an intra-aortic balloon pump showed artifacts, but higher diastolic blood flow velocity allowed distinction of the internal carotid artery.
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