Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis

D. B. Hood, M. A. Mattos, A. Mansour, D. E. Ramsey, K. J. Hodgson, L. D. Barkmeier, D. S. Sumner, Gregory (Greg) Moneta, W. S. Moore

Research output: Contribution to journalArticle

124 Citations (Scopus)

Abstract

Purpose: Large multicenter trials (North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial) have documented the benefits of carotid endarterectomy for treating symptomatic patients with ≥70% stenosis of the internal carotid artery. Although color-flow duplex scanning has become the preferred method for noninvasive assessment of internal carotid artery disease, no criteria have been generally accepted to identify this subset of patients. We previously reported a retrospective series to establish such criteria. This study details our results when these criteria were applied prospectively. Methods: Carotid color-flow duplex scans were compared with arteriograms in 457 patients who underwent both studies. Criteria for ≥70% internal carotid artery stenosis were peak systolic velocity >130 cm/sec and end-diastolic velocity >100 cm/sec. Internal carotid arteries with peak systolic velocity 90%) stenosis (n = 5) and to interpreter error (n = 1); no explanation was apparent in the other four. Eleven of 12 false-negative examinations occurred in patients with 70% to 80% internal carotid artery stenosis. Conclusions: In our laboratories, prospective application of the above velocity criteria identified internal carotid artery stenosis of ≥70% with a reasonably high degree of accuracy. Errors occurred when stenoses were borderline and in patients with severe contralateral disease. With suitably modified velocity criteria, color-flow duplex scanning remains the most reliable noninvasive method for identifying symptomatic patients who are candidates for carotid endarterectomy.

Original languageEnglish (US)
Pages (from-to)254-262
Number of pages9
JournalJournal of Vascular Surgery
Volume23
Issue number2
DOIs
StatePublished - 1996
Externally publishedYes

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Carotid Stenosis
Carotid Endarterectomy
Color
Pathologic Constriction
Carotid Artery Diseases
Internal Carotid Artery
Multicenter Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Hood, D. B., Mattos, M. A., Mansour, A., Ramsey, D. E., Hodgson, K. J., Barkmeier, L. D., ... Moore, W. S. (1996). Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis. Journal of Vascular Surgery, 23(2), 254-262. https://doi.org/10.1016/S0741-5214(96)70269-0

Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis. / Hood, D. B.; Mattos, M. A.; Mansour, A.; Ramsey, D. E.; Hodgson, K. J.; Barkmeier, L. D.; Sumner, D. S.; Moneta, Gregory (Greg); Moore, W. S.

In: Journal of Vascular Surgery, Vol. 23, No. 2, 1996, p. 254-262.

Research output: Contribution to journalArticle

Hood, DB, Mattos, MA, Mansour, A, Ramsey, DE, Hodgson, KJ, Barkmeier, LD, Sumner, DS, Moneta, GG & Moore, WS 1996, 'Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis', Journal of Vascular Surgery, vol. 23, no. 2, pp. 254-262. https://doi.org/10.1016/S0741-5214(96)70269-0
Hood, D. B. ; Mattos, M. A. ; Mansour, A. ; Ramsey, D. E. ; Hodgson, K. J. ; Barkmeier, L. D. ; Sumner, D. S. ; Moneta, Gregory (Greg) ; Moore, W. S. / Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis. In: Journal of Vascular Surgery. 1996 ; Vol. 23, No. 2. pp. 254-262.
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abstract = "Purpose: Large multicenter trials (North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial) have documented the benefits of carotid endarterectomy for treating symptomatic patients with ≥70{\%} stenosis of the internal carotid artery. Although color-flow duplex scanning has become the preferred method for noninvasive assessment of internal carotid artery disease, no criteria have been generally accepted to identify this subset of patients. We previously reported a retrospective series to establish such criteria. This study details our results when these criteria were applied prospectively. Methods: Carotid color-flow duplex scans were compared with arteriograms in 457 patients who underwent both studies. Criteria for ≥70{\%} internal carotid artery stenosis were peak systolic velocity >130 cm/sec and end-diastolic velocity >100 cm/sec. Internal carotid arteries with peak systolic velocity 90{\%}) stenosis (n = 5) and to interpreter error (n = 1); no explanation was apparent in the other four. Eleven of 12 false-negative examinations occurred in patients with 70{\%} to 80{\%} internal carotid artery stenosis. Conclusions: In our laboratories, prospective application of the above velocity criteria identified internal carotid artery stenosis of ≥70{\%} with a reasonably high degree of accuracy. Errors occurred when stenoses were borderline and in patients with severe contralateral disease. With suitably modified velocity criteria, color-flow duplex scanning remains the most reliable noninvasive method for identifying symptomatic patients who are candidates for carotid endarterectomy.",
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