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Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound
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2018 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 60, no 1, p. 17-25Article in journal (Refereed) Published
Abstract [en]

Purpose: Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis.

Methods: Included patients had near-occlusion or conventional stenosis with carotid ultrasound and CT angiogram (CTA) performed within 30 days of each other. CTA examinations were analyzed by two blinded expert readers. Velocities in the internal and common carotid arteries were recorded. Mean velocity, pulsatility index, and ratios were calculated, giving 12 Doppler parameters for analysis.

Results: Of 136 patients, 82 had conventional stenosis and 54 had near-occlusion on CTA. Of near-occlusions, 40 (74%) had high PSV (≥ 125 cm/s) across the stenosis. Ten Doppler parameters significantly differed between conventional stenosis and high-velocity near-occlusion groups. However, no parameter was highly sensitive and specific to separate the groups.

Conclusion: Near-occlusions frequently have high PSV across the stenosis, particularly those without full collapse. Carotid Doppler ultrasound does not seem able to distinguish conventional stenosis from high-velocity near-occlusion. These findings question the use of ultrasound alone for preoperative imaging evaluation.

Place, publisher, year, edition, pages
2018. Vol. 60, no 1, p. 17-25
Keywords [en]
Carotid stenosis, Ultrasonography, X-ray computed tomography, Angiography, Internal carotid artery, LONG ER, 1988, BIOMETRICS, V44, P837 ftus IM, 1998, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, V16, P489 rst J., 2015, AMERICAN JOURNAL OF NEURORADIOLOGY, V36, P1978 n Reutern Gerhard-Michael, 2012, STROKE, V43, P916 clerc X, 1999, RADIOLOGY, V210, P673 naboldo C, 1991, European journal of vascular surgery, V5, P415
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-144100DOI: 10.1007/s00234-017-1938-4ISI: 000419127000004PubMedID: 29177789OAI: oai:DiVA.org:umu-144100DiVA, id: diva2:1179717
Available from: 2018-02-02 Created: 2018-02-02 Last updated: 2018-06-09Bibliographically approved

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Grönlund, ChristerWester, Per

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Department of Radiation SciencesDepartment of Pharmacology and Clinical NeuroscienceDepartment of Public Health and Clinical Medicine
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Neuroradiology
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