Adopt Transcranial Doppler Ultrasonography And Digital Subtract Angiography Determination Of The Lower Limit Of Cerebral Auto-regulation

Objective Adopt transcranial doppler ultrasonography and digital subtract angiography determination of invasive critical closing pressure and lower limit of cerebral auto-regulation in59 patients,To investigate the method of noninvasively and invasively estimating critical closing pressure and the lower limit of cerebral auto-regulation whether have Statistical differences in human. understand each patient's lower limit of cerebral auto-regulation. Realizion personalized blood pressure management.Methods Transcranial doppler velocities and noninvasive blood pressure in radial artery and invasive blood pressure in aortic arch and common carotid artery were continuously recorded in 59 patients. CCPs and LLCAs were calculated by two different methods. Narrow group and normal group were classified according the digital subtract angiography results. To compare the method of narrow group with normal group estimating critical closing pressure and the lower limit of cerebral auto-regulation whether have Statistical differences in human.Results1. The Patients with the normal digital subtract angiography group. The aortic arch invasively blood pressure's MABP(106.57±20.429 mmHg) was lower than the left common carotid artery's MABP(109.22±20.155 mmHg)and the right common carotid artery's MABP(107.04±19.665 mmHg), the results had Statistical differences(P<0.05).the results were not conform to the normal human hemodynamic changes. Consider catheter causes the results. The aortic arch invasively blood pressure was not accurate. Using common carotid artery invasively blood pressure were analyzed.2. The Patients with the normal digital subtract angiography group, the CCP(43.64±29.03 mmHg),LLCA(65.57±22.32 mmHg) calculated by the left radial artery invasively blood pressure compare with CCP(45.17±20.76 mmHg),LLCA(63.52±14.36mmHg)calculated by the radial artery noninvasively blood pressure had no Statistical differences. the CCP(45.86±31.31 mmHg),LLCA(62.56±22.54 mmHg)calculated by the right radial artery invasively blood pressure compare with CCP(48.36±18.92mmHg),LLCA(58.68±11.74mmHg)calculated by the radial artery noninvasively blood pressure had no Statistical differences.3. The Patients with the narrow digital subtract angiography group, the CCP(77.49±44.37mmHg),LLCA(45.02±36.31 mmHg)calculated by the left radial artery invasively blood pressure compare with CCP(58.00±33.43mmHg),LLCA(54.96±27.83 mmHg)calculated by the radial artery noninvasively blood pressure had Statistical differences(P<0.05). the CCP(69.68±43.34mmHg),LLCA(47.74±34.01mmHg)calculated by the right radial artery invasively blood pressure compare with CCP(54.97±26.15mmHg),LLCA(55.60±20.66mmHg)calculated by the radial artery noninvasively blood pressure had Statistical differences(P<0.05).4. The CCP(44.42±7.45mmHg),LLCA(64.49±5.93mmHg)calculated by the left radial artery invasively blood pressure of the patients with the normal digital subtract angiography group compare with the CCP(77.95±6.60mmHg),LLCA(46.61±5.25 mmHg)calculated by the left radial artery invasively blood pressure of narrow digital subtract angiography group had Statistical differences ( P<0.05 ) .The CCP(46.22±7.47 mmHg ),LLCA(62.96±5.76 mmHg)calculated by the right radial artery invasively blood pressure of the patients with the normal digital subtract angiography group compare with the CCP(70.33±6.83mmHg ),LLCA(49.88±5.26mmHg)calculated by the right radial artery invasively blood pressure of narrow digital subtract angiography group had Statistical differences(P<0.05).Conclusion1. The Patients with the normal digital subtract angiography group. CCP and LLCA calculated by the radial artery noninvasively blood pressure was accurate.2. The Patients with the narrow digital subtract angiography group. Angiostenosis had influential To CCP and LLCA. CCP and LLCA calculated by the radial artery noninvasively blood pressure was not accurate. CCP and LLCA should calculate by the invasively blood pressure.3. CCP and LLCA calculated by the blood pressure before angiostenosis were not accurate. CCP and LLCA should calculate by the blood pressure distal angiostenosis.