Validating common carotid stenosis by duplex ultrasound with carotid angiogram or computed tomography scan

Abstract

Establishing CCA duplex criteria to screen patients with significant stenosis is crucial to identify those who will need further imaging modality or treatment. In our laboratory, CCA PSV ≥250 cm/s and EDV ≥60 cm/s are thresholds that can be used to identify significant (>60%) CCA stenosis with a high degree of accuracy.

Common carotid artery peak systolic velocity ratio predicts high-grade common carotid stenosis

“…This is evident by the wide range of velocity parameters reported in the literature, with PSV threshold between 150 cm/s and 250 cm/s to predict >50% CCA stenosis. 4,5,11 In the present study, we evaluated a ratio parameter hat uses the contralateral CCA as a reference point to minimize the physiologic bias introduced by hemodynamic variability because both CCAs share similar physiologic and anatomic characteristics at the level accessible by DUS. Also, this is the first study to report the anatomic distribution and prevalence of bilateral CCA stenosis, using advanced imaging with CTA.…”

“…[3][4][5] One significant limitation of those methods is that they are based on unilateral peak systolic velocity (PSV) and end-diastolic velocity (EDV) criteria alone, which may be subject to error because of within-patient and between-patients hemodynamic variability. 2,[6][7][8] Although this applies to all patients of different age, gender, and comorbidities, 9 it is particularly important in patients hypertensive or hypotensive, with hyperdynamic circulation, depressed cardiac ejection fraction, and valvulopathy, all of which may result in a wide range of CCA velocities in patients with the same location and degree of stenosis.…”

Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis

“…Duplex sonography was primarily performed, and the degree of stenosis was evaluated by the peak systolic and end-diastolic velocity in all extracranial and extrathoracic vessels according to the criteria of the North American Symptomatic Carotid Endarterectomy Trial (NASCET) [ 16 , 17 ]. A validation of duplex sonography with a threshold PSV ≥ 250 cm/s and EDV ≥ 60 cm/s, to identify significant (>60%) CCA stenosis, was depicted by Matos et al, and was also used in our center as cut-off values for further imaging [ 18 ]. A verification of the diagnosis was performed via computed tomography angiography or magnetic resonance angiography, as recommended in the current ESVS guidelines [ 16 ].…”

The effect of norepinephrine on common carotid artery blood flow in septic shock patients

“…Additionally, patients who were receiving or had received a vasopressor within 24 h prior to the study were excluded. Patients with a CCA stenosis degree of ≥ 50% on carotid ultrasonography (PSV > 150 cm/s with post stenotic turbulence) and those with a medical history of CCA stenosis were excluded 21 , 22 . Patients who were unable to undergo follow-up ultrasonography and who did not give consent to the use of their data were also excluded.…”