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Blood, Vol. 112, Issue 10, 4314-4317, November 15, 2008
G6PD deficiency, absence of  -thalassemia, and hemolytic rate at baseline are significant independent risk factors for abnormally high cerebral velocities in patients with sickle cell anemia
Blood Bernaudin et al.
112: 4314
Supplemental materials for: Bernaudin et al
Transcranial Color Doppler imaging (TCDI) was performed using imaging equipment (Acuson, GE Medical Systems, Hitachi). Using the temporal and suboccipital approach, time averaged maximum mean flow velocity (TAMMX) was obtained in the distal internal carotid artery, the middle cerebral artery from the MCA/ACA bifurcation to the peripheral location, the initial anterior cerebral artery, the posterior cerebral artery and the basilar artery. No angle correction was used. The envelope of the waveform was traced manually or electronically depending on the quality of the waveform. Accordingly to Adams (STOP study), velocities were considered as abnormally high when TAMMX was at least higher than 200 cm/sec in MCA, ACA or ICA. TCD was performed once a year or once a trimester when conditional (170–199 cm/sec). However, contrary to the STOP study, since August 2001, we have initiated transfusion programs after the first abnormal TCD because a young girl followed since birth in our center with abnormal high velocities detected at the age of 1.5 years had a stroke at the age of 1.6 years just before the TCD control and the initiation of the transfusion program. Since this observation, we decided to begin the TP after the first abnormal TCD.
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