Correlation of North American Symptomatic Carotid Endarterectomy Trial (NASCET) angiographic definition of 70% to 99% internal carotid artery stenosis with duplex scanning

Archie, Joseph P.; Moneta, Gregory L.; Edwards, James M.; Chitwood, Richard W.; Taylor, Lloyd M.; Lee, Raymond W.; Cummings, Cary A.

doi:10.1067/mva.1993.42888

Cited by 71 publications

(24 citation statements)

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“…In our study, the spectral analysis is based on the peak systolic velocity (PSV) measurement accordingly to the generally accepted published criteria. The NASCET published criteria for velocity values predicting 70–99% stenosis show PSV values ranging between 130 and 325 cm/s, the best parameter being an end diastolic velocity >100 cm/s and an internal carotid artery PSV/common carotid artery PSV ratio >4.0 [33, 34]. The best ACAS-published criteria for velocity values predicting 60–99% stenosis is a PSV value >170 cm/s [35].…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Computed Tomography Angiography and Magnetic Resonance Angiography of Carotid Bifurcation Stenosis

Binaghi¹,

Maeder²,

Uské³

et al. 2001

Eur Neurol

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Purpose: To evaluate the role of computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in the quantification of atherosclerotic stenosis of carotid artery bifurcation in comparison with digital substraction angiography (DSA) and Doppler sonography (DS). Materials and Methods: Twenty-five patients with atherosclerotic disease of the carotid arteries with proven stenosis by DSA, had spiral CTA, MRA using two- and three-dimensional time-of-flight gradient echo techniques, and DS using Doppler flow signal recording (total 47 carotid artery bifurcations). The degree of stenosis was measured according to the North American Symptomatic Carotid Endarterectomy Trial criteria: total occlusion (100%), severe (70–99%), moderate (30–69%) and mild (0–29%). The degree of stenosis measured by CTA, MRA and DS was compared to DSA, used as the gold standard. Results: Ninety-seven percent of MRA measures were equivalent to DSA, and 3% were underestimated; 96% of CTA measures were equivalent to DSA, and 4% were underestimated; 77% of DS measures were equivalent to DSA, 21% were overestimated and 2% were underestimated. Conclusions: CTA and MRA are equally accurate methods in quantifying the degree of carotid bifurcation stenosis.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Computed Tomography Angiography and Magnetic Resonance Angiography of Carotid Bifurcation Stenosis

Binaghi¹,

Maeder²,

Uské³

et al. 2001

Eur Neurol

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“…All patients were examined by the same investigator (A.W.J.H.). Stenosis of the carotid arteries was graded according to previously defined criteria [22]. TCCD was performed with a 2.0- to 2.5-MHz phased-array probe.…”

Section: Methodsmentioning

confidence: 99%

Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke

et al. 2003

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Background: Autopsy studies show a higher prevalence of circle of Willis anomalies in brains with signs of ischemic infarction. Our goal was to examine the collateral function of the circle of Willis in ischemic stroke patients and to assess in a case-control study if a collateral deficient circle of Willis is a risk factor for ischemic stroke in patients with severe internal carotid artery (ICA) occlusive disease. Methods: Our case-control study included 109 patients with an acute ischemic stroke in the anterior circulation and 113 patients with peripheral arterial disease and no known history of cerebral ischemia. The collateral function of the anterior and posterior communicating arteries of the circle of Willis was assessed by means of transcranial color-coded duplex ultrasonography (TCCD) and carotid compression tests. Results: TCCD was successfully performed in 75 case patients (mean age 64 years, range 41–91 years) and in 100 control patients (mean age 61 years, range 35–89 years). In 26 cases and 19 controls, a ≧70% stenosis or occlusion of the ICA was found. A nonfunctional anterior collateral pathway in the circle of Willis was found in 33% of the cases and in 6% of the controls (p < 0.001). The posterior collateral pathway was nonfunctional in 57% of the cases and in 43% of the controls (p = 0.02). In patients with severe ICA occlusive disease, the odds ratios of a nonfunctional anterior and a nonfunctional posterior collateral pathway were 7.33 (95% confidence interval, CI, = 1.19–76.52) and 3.00 (95% CI = 0.77–12.04), respectively. Conclusions: Patients who suffer ischemic stroke in the anterior circulation have a higher incidence of collateral deficient circles of Willis than those with atherosclerotic vascular disease without ischemic cerebrovascular disease. The presence of a nonfunctional anterior collateral pathway in the circle of Willis in patients with severe ICA occlusive disease is strongly associated with ischemic stroke.

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“…This group, as defined by conventional peak systolic velocity-based Doppler criteria, appears to be highly inhomogeneous. Our data indicate that widely used ultrasound criteria focusing exclusively on the peak systolic velocity [16, 17, 18]or angiography criteria [19, 20]are not sufficient enough to distinguish between hemodynamic critical or fully compensated stenoses. Our results underline the necessity to implement additional markers of the hemodynamic impact of a carotid stenosis beside peak systolic velocity.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of stenosis in groups II and III was based on peak systolic flow velocity measurements. The Doppler criteria were chosen to correlate best with the NASCET criteria of extracranial carotid disease [16, 17]. Based on angiographic comparison in our department, we defined the following criteria.…”

Section: Methodsmentioning

confidence: 99%

Volume Flow Rate Evaluation in Patients with Obstructive Arteriosclerotic Disease

Paulus

Reimers

et al. 2004

Cerebrovasc Dis

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This study was performed to quantify the volumetric impact of extracranial arteriosclerotic lesions. We investigated patients with different degrees of carotid stenosis as defined by conventional velocity-based duplex criteria and different patterns of collateralization. We studied the volume flow rate (color duplex M-mode device) in 37 patients with symmetrical internal carotid artery (ICA) plaques (<50% stenosis) and compared these data to 43 patients with a unilateral 50–74% stenosis, 75–99% stenosis (n = 73) and occlusion of the ICA (n = 37). A 75–99% stenosis caused an ipsilateral flow reduction of 36% with a wide interindividual variability, and an occlusion of 51%. Collateralization via the ophthalmic artery only caused a nonsignificant ipsilateral volume flow increase, whereas the contralateral volume flow was significantly higher in patients with a patent anterior communicating artery. The increase was more pronounced in patients with an occluded vessel. Our data demonstrate a wide diversity of the hemodynamic impact of carotid stenosis as defined by ‘classical’ Doppler criteria. Collateral flow reflects a dynamic quantitative process.

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Correlation of North American Symptomatic Carotid Endarterectomy Trial (NASCET) angiographic definition of 70% to 99% internal carotid artery stenosis with duplex scanning

Abstract: These results support an aggressive attempt to obtain a complete or optimal ICA endpoint with reconstruction techniques based on operative findings. Recognition of patients at risk for and treatment of hyperperfusion syndrome after CEA remains a clinical challenge.

Cited by 71 publications

References 0 publications

Three-Dimensional Computed Tomography Angiography and Magnetic Resonance Angiography of Carotid Bifurcation Stenosis

Three-Dimensional Computed Tomography Angiography and Magnetic Resonance Angiography of Carotid Bifurcation Stenosis

Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke

Volume Flow Rate Evaluation in Patients with Obstructive Arteriosclerotic Disease

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