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PubMed · 8017069

[Electrotherapy].

K Ammer
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Abstract

Electrotherapy is defined as the sum of therapeutic modalities of physical medicine capable to change the threshold of elicitation of nerve or muscle. Classification due to applied pulse frequencies, way of action of transcutaneous nerve stimulation (= TENS) and of iontophoresis is described. Pain syndromes, muscle atrophy by loss of activity and support of wound healing are named as accepted indications for electrotherapy. The difficulties of electrical stimulation of paretic muscles and the problem, whether different indications for certain forms of electrotherapy exist or not, is discussed.

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Arterial Occlusive DiseasesElectric Stimulation TherapyHumansNeuromuscular DiseasesTranscutaneous Electric Nerve StimulationEnglish AbstractJournal ArticleReview

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BibTeXRIS

K Ammer. 1994. [Electrotherapy].. https://pubmed.ncbi.nlm.nih.gov/8017069/

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Detection of sub-critical arterial stenoses by hyperaemic Doppler.

OBJECTIVES: This study assessed the potential of hyperaemic Doppler to detect sub-critical stenoses using a flowrig model. METHODS: Pulsatile flow of a blood substitute was produced in a compliant circuit. A cadaver carotid artery, constricted by a silk suture produced a variable, focal stenosis. Forty-seven stenoses were created in five arteries. Pressure gradients and Doppler measurements were recorded simultaneously across each stenosis at low (200 ml/min) and high (400 ml/min) flow rates. The change in peak velocities between the arterial segment 2cm proximal to the stenosis (V1), and the stenotic jet (V2) were used to calculate three Doppler indices: (i) V2/V1 ratio, (ii) V2-V1 difference, (iii) a modified 'Bernoulli' value. A high flow pressure gradient of > or = 15% of the resting distal pressure (% delta P), represented a significant stenosis. RESULTS: There was improved correlation between Doppler indices and % delta P at high flow (r = 0.87 to 0.88) compared to low flow rates (r = 0.81 to 0.84). Optimum V2/V1 cut off values were determined by received operator characteristics (ROC) curve analysis. At low flow five sub-critical stenoses were not detected (sensitivity 82.8%) yet all but one of these lesions were identified at high flow (sensitivity of 96.6%). The V2-V1 and Bernoulli indices did not improve on the discriminant ability of the V2/V1 ratio. CONCLUSIONS: The V2/V1 ratio is sensitive to haemodynamic changes at enhanced flow rates across ideal arterial stenoses. The potential of hyperaemic Doppler to detect sub-critical lesions and so avoid intraarterial pressure measurements deserves further in vivo study.

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