Standard duplex criteria overestimate the degree of stenosis after eversion carotid endarterectomy

Benzing, Travis; Wilhoit, Cameron; Wright, Sharee; McCann, P. Aaron; Lessner, Susan M.

doi:10.1016/j.jvs.2015.01.039

Cited by 8 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[34][35][36][37][38] Emerging data suggest the need for similar revisions to velocity criteria after CEA; however, additional studies need to be performed before firm recommendations can be made. 40,41…”

Section: Risk Factors For Carotid Restenosismentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures

Zierler

Jordan

Lal

et al. 2018

Journal of Vascular Surgery

129

View full text Add to dashboard Cite

Although follow-up after open surgical and endovascular procedures is generally regarded as an important part of the care provided by vascular surgeons, there are no detailed or comprehensive guidelines that specify the optimal approaches with regard to testing methods, indications for reintervention, and follow-up intervals. To provide guidance to the vascular surgeon, the Clinical Practice Council of the Society for Vascular Surgery appointed an expert panel and a methodologist to review the current clinical evidence and to develop recommendations for follow-up after vascular surgery procedures. For those procedures for which high-quality evidence was not available, recommendations were based on observational studies, committee consensus, and indirect evidence. Recognizing that there are numerous published reports on the role of duplex ultrasound for surveillance of infrainguinal vein bypass grafts, the Society commissioned a systematic review and meta-analysis on this topic. The panel classified the strength of each recommendation and the corresponding quality of evidence on the basis of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system: recommendations were graded either strong or weak, and the quality of evidence was graded high, moderate, or low. The resulting recommendations represent a wide variety of open surgical and endovascular procedures involving the extracranial carotid artery, thoracic and abdominal aorta, mesenteric and renal arteries, and lower extremity arterial revascularization. The panel also identified many areas in which there was a lack of high-quality evidence to support their recommendations. This suggests that there are opportunities for further clinical research on testing methods, threshold criteria, and the role of surveillance as well as on the modes of failure and indications for reintervention after vascular surgery procedures.

show abstract

Section: Risk Factors For Carotid Restenosismentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures

Zierler

Jordan

Lal

et al. 2018

Journal of Vascular Surgery

129

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…1,6,14 Therefore, standardizing cut-off values for parameters is of great significance for patient screening and evaluating clinical treatment. However, in the early 1990s, some studies [7][8][9] reported that diagnostic criteria assessed using CDU overestimated the stenosis degree for bilateral carotid artery stenosis. In 1998, van Everdingen et al 7 revealed that this overestimation was due to one side of the ICA being occluded and causing blood flow to increase on the other side of the ICA with carotid artery stenosis; this was confirmed by cerebral blood flow perfusion on MRI.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Moreover, following the eversion technique for CEA, the degree of restenosis evaluated by CDU based on previous blood flow velocity criteria was overestimated. 9 However, the reason for this phenomenon is rarely mentioned in previous literature. In the clinical practice of our center, we have noticed that the anterior communicating artery patency will have a certain impact on the flow velocity measurement of the intracranial segment of the internal carotid artery (ICA).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of anterior communicating artery patency on the flow velocity in bilateral carotid artery stenosis after carotid endarterectomy

et al. 2023

View full text Add to dashboard Cite

Background: The effect of anterior communicating artery (ACoA) patency on the flow velocity of the extracranial carotid arteries is unclear. Methods: A total of 285 patients with carotid artery stenosis were included between January 2019 and January 2021. All patients received unilateral carotid endarterectomy (CEA). The patients were classified into ACoA-patent (161) and ACoA-nonpatent (124) groups using digital subtraction angiography (DSA) and/or computed tomography angiography (CTA). The peak systolic velocity (PSV) and end-diastolic velocity (EDV) measured by carotid duplex ultrasonography (CDU) were compared between both groups, pre- and post-CEA. Results: There was no significant difference in the risk factors for cerebrovascular disease between the two groups. Within 1 week after CEA, the PSV and EDV on operative and nonoperative carotid (contralateral carotid in the same patient) arteries decreased significantly (both p < 0.01). Comparison of nonoperative carotid artery pre- and post-CEA between the two groups showed that post-CEA PSV and EDV in the ACoA-patent group were significantly lower than that of pre-CEA (PSV and EDV, t = 11.507 and 6.716, respectively, both p < 0.001) (according to the Society of Radiologists in Ultrasound Consensus Conference [SRUCC] PSV standard). There was no significant difference in the ACoA-nonpatent group (PSV: t = 1.924, p = 0.057; EDV: t = 1.237, p = 0.218). In the nonoperative carotid artery of the ACoA-patent group, the degree of stenosis assessed by CDU was inconsistent with that of DSA/CTA (κ = 0.294), whereas that in the ACoA-nonpatent group had a high consistency (κ = 0.982). Among 161 ACoA-patent cases, 68 showed overestimated stenosis. Conclusions: The patent ACoA increases PSV and EDV, causing an overestimation of carotid artery stenosis.

show abstract

“…In the absence of prospective large-scale multicenter studies making this comparison, single-center studies like those from Brothers and colleagues 4 and Abraham et al 5 are very helpful as we examine outcomes after CEA. We continue to believe that an operationally more relevant measure is freedom from reintervention, and it is clear that eversion and conventional CEA are both durable and provide a very high rate of freedom from reintervention.…”

Section: Replymentioning

confidence: 99%

Reply

Schneider

Hoel

2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

Standard duplex criteria overestimate the degree of stenosis after eversion carotid endarterectomy

Abstract: The presence of hemodynamically significant carotid artery restenosis may be overestimated by standard duplex criteria after eCEA and perhaps after pCEA. Insufficient information currently exists to determine what PSV does correspond to hemodynamically significant restenosis.

Cited by 8 publications

References 34 publications

The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures

The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures

Effect of anterior communicating artery patency on the flow velocity in bilateral carotid artery stenosis after carotid endarterectomy

Reply

Contact Info

Product

Resources

About