Vertebral and internal carotid artery flow during vascular premanipulative testing using duplex Doppler ultrasound measurements: A systematic review

ObjectivesTo systematically review cervical artery blood flow behaviour by duplex Doppler ultrasonography with different cervical movements often used during vascular premanipulative testing.MethodsPRISMA guidelines were followed to conduct this systematic review. Electronic search was carried out using the following databases: Pubmed, Web of Science, ScienceDirect, Scopus, IME, Dialnet, Lilacs, ENFISPO and AMED. Observational studies focussing on the duplex Doppler ultrasound measurements of cervical artery flow (VA or ICA) in different cervical positions were included. Studies selection was conducted by two reviewers who screened firstly for titles, then for abstracts and finally for full articles. The following data were extracted from the studies: author, year, sample, measurements and instruments, cervical movement and results.Results379 records were identified. Seven articles met the inclusion criteria and were considered for this systematic review. Five studies tested only vertebral artery flow, one study assessed internal carotid artery flow and the remaining study examined both. There is a lack of homogeneity concerning the samples included in the studies (age, sex and presence or absence of symptoms) and the methodology used for measuring blood flow. Four out of the seven studies did not obtain any significant decrease of cervical arteries blood flow in different neck positions, while the remaining three studies found a significant decrease of the contralateral vertebral artery blood flow.ConclusionsResults of the studies included in this systematic review show no consensus. Further research and better methodological designs are required to analyze cervical artery blood flow behaviour with different neck movements and elucidate the role of vascular premanipulative testing.