scholarly journals Digital Subtraction Angiogram (DSA) is Superior to Duplex Ultrasound (USD) in Diagnosis of Extracranial Carotid Stenosis - A Comparative Study

1970 ◽  
Vol 12 (1) ◽  
pp. 12-16
Author(s):  
Rajib Nayan Chowdhury ◽  
Kazi Mohibur Rahman ◽  
Shariff Uddin Khan ◽  
Rabindranath Sarker ◽  
Shahriar Nabi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Arteries ◽  
Duplex Ultrasound ◽  
Diagnostic Efficiency ◽  
Digital Subtraction ◽  
Key Word ◽  
Digital Subtraction Angiogram ◽  
Sensitivity Specificity ◽  
Carotid Vessels

This retrospective crossectional observational study was conducted in the department of Neurology, DMCH, Dhaka from December 2008 to December 2009. This study included a total of 40 patients, out of all, 35 suffered from nondisabling ischaemic stroke, other 5 had TIAs. Patients with ≥50% extracranial carotid stenosis on Duplex Ultrasound were then selected for DSA. DSA was done on these vessels and stenosis was measured using NASCET criteria. Results of USD and DSA were compared to determine the sensitivity, specificity and accuracy of Duplex Ultrasound (USD). ROC graph of RICA and LICA showed that most left and upper point of the curve lies at the level of 70% stenosis. At ≥70% stenosis of RICA and LICA the Sensitivity, Specificity and Accuracy were 91.2%, 50%, 85% and 86.83%, 50%, 85% respectively. This level of diagnostic efficiency of USD is less than that of DSA of carotid arteries. Study revealed that USD underestimates or overestimates degree of carotid stenosis, and DSA is safe and effective in determining stenosis. So before taking any decision to intervene in the form of Carotid endarterectomy or carotid artery stenting, it would be wise to do Digital Subtraction Angiogram of carotid vessels. Key word: Digital Subtraction Angiogram; Duplex Ultrasound; carotid vessels. DOI: 10.3329/jom.v12i1.6926J Medicine 2011; 12 : 12-16

scholarly journals Digital subtraction angiography (DSA) is superior to duplex ultrasound in diagnosis of extracranial carotid stenosis - a comparative study

2014 ◽  
Vol 43 (2) ◽  
pp. 67-71
Author(s):  
Subash Kanti Dey ◽  
Lipy Bakshi ◽  
Md Shahidullah ◽  
Ahsan Habib ◽  
Manabendra Battacharya ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Digital Subtraction Angiography ◽  
Internal Carotid ◽  
Duplex Ultrasound ◽  
Digital Subtraction ◽  
Sensitivity Specificity ◽  
Carotid Vessels

Digital subtraction angiography (DSA) is the gold standard investigation to assess the extracranial stenosis of carotid vessels. But this is an invasive diagnostic tool. So it is still a controversial issue whether duplex ultrasound is an alternative to DSA for measurement of stenosis of carotid vessels. This prospective crossectional observational study was conducted in the department of Neurology, BSMMU, Dhaka from May 2012 to April 2013 to assess the diagnostic accuracy of duplex ultrasound and its potential to replace DSA before performing carotid endarterectomy (CEA) and carotid stenting. Total of 38 patients, 33 patients of nondisabling ischaemic stroke and 5 patients with history of TIAs whose extracranial carotid stenosis was >50% on duplex ultrasound were selected for DSA. DSA was done on these vessels and stenosis was measured using NASCET criteria. Results of USD and DSA were compared to determine the sensitivity, specificity and accuracy of duplex ultrasound (USD). At 70% stenosis of right internal carotid artery and left internal carotid artery the sensitivity, specificity and accuracy were 93.8%, 63.7%, 89.5% and 93.3%, 75%, 89.5% respectively. This level of diagnostic efficiency of USD is less than that of DSA of carotid arteries. It was found in this study that, USD underestimates or overestimates the degree of carotid stenosis. DSA was safe and effective in determining stenosis in this study & there was no 67 complication. So before taking any decision for carotid endarterectomy or carotid artery stenting, digital subtraction angiography of carotid vessels should be done. DOI: http://dx.doi.org/10.3329/bmj.v43i2.21385 Bangladesh Med J. 2014 May; 43 (2): 67-71

scholarly journals It was a Supraclinoid Stenosis Rather Than Extracranial Carotid Stenosis

1970 ◽  
Vol 20 (1) ◽  
pp. 75-77
Author(s):  
RN Chowdhury ◽  
KM Rahman ◽  
SU Khan ◽  
RN Sarker ◽  
S Nabi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Common Carotid Artery ◽  
Significant Risk ◽  
Duplex Ultrasound ◽  
Significant Risk Factor ◽  
Internal Carotid Artery Stenosis ◽  
Digital Subtraction ◽  
Digital Subtraction Angiogram ◽  
Key Words Carotid Stenosis

Carotid stenosis, both intracranial and extracranial is a significant risk factor for transient ischaemic attack and ischaemic stroke. Significant carotid stenosis increases the risk of artery to artery embolization. Duplex Ultrasound (USD) is a screening test for identification and grading of carotid stenosis. USD is less sensitive and specific than cerebral Digital Subtraction Angiogram (DSA) for evaluation of carotid stenosis. USD might underestimate or overestimate degree of carotid stenosis. Here a case is presented where USD found bilateral significant extracranial carotid stenosis, whereas DSA reported no right common carotid artery and left common carotid artery bifurcation stenosis rather there was significant 70% supraclinoid right internal carotid artery stenosis. Key words: Carotid stenosis; Supraclinoid stenosis; Duplex ultrasound examination; Digital subtraction angiogram DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8586 J Dhaka Med Coll. 2011; 20(1) :75-77

scholarly journals Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

2014 ◽  
Vol 47 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Vilson Lacerda Brasileiro Junior ◽  
Aníbal Henrique Barbosa Luna ◽  
Marcelo Augusto Oliveira de Sales ◽  
Tânia Lemos Coelho Rodrigues ◽  
Priscilla Lopes da Fonseca Abrantes Sarmento ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Carotid Arteries ◽  
Panoramic Radiography ◽  
Digital Panoramic Radiography ◽  
Significant Difference ◽  
Mcnemar’S Test ◽  
Sensitivity Specificity

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

From embolization to remodeling: the need for early carotid endarterectomy in symptomatic carotid plaques

Vascular ◽  
2011 ◽  
Vol 19 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Laura Capoccia ◽  
Caterina Pelonara ◽  
Cesira Imondi ◽  
Enrico Sbarigia ◽  
Francesco Speziale
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Duplex Ultrasound ◽  
Left Carotid Artery ◽  
Symptomatic Carotid ◽  
Atheromatous Plaques ◽  
Dynamic Structures ◽  
Arterial Stenoses

Atheromatous plaques are dynamic structures undergoing continuous remodeling. Duplex ultrasound is now an accepted technique to classify the severity of arterial stenoses. It gives information about the ultrasonic echogenicity of tissue, the plaque surface and the velocity of blood flowing through vessels with the latest equipment. We report the case of a 59-year-old male patient with left hemispheric stroke and a 50% left carotid artery stenosis whose remodeling and reabsorption developed throughout three months from the onset of symptoms. Plaque surface and structural echomorphology assessment and standardization, along with the degree of carotid stenosis, might be helpful in identifying patients most likely to benefit from carotid endarterectomy.

scholarly journals Quantitative susceptibility mapping improves the detection of calcified carotid vessels by multi-contrast MRI using computed tomography angiography as the reference standard

2021 ◽  
Author(s):  
Thanh D Nguyen ◽  
Yan Wen ◽  
Jingwen Du ◽  
Pascal Spincemaille ◽  
Yi Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Vessel Wall ◽  
Carotid Arteries ◽  
Susceptibility Mapping ◽  
Reference Standard ◽  
Quantitative Susceptibility Mapping ◽  
Vessel Detection ◽  
Carotid Vessel Wall ◽  
Carotid Vessels

The objective of this study was to evaluate initial feasibility and improvement in the detection of calcified carotid arteries by including quantitative susceptibility mapping (QSM) in the carotid vessel wall multi-contrast MRI (mcMRI) protocol using CTA as the reference standard. In a pilot cohort of ten patients with significant carotid artery stenosis, calcified vessel detection by mcMRI achieved 64.7% sensitivity and 100% specificity. Adding QSM to mcMRI improved sensitivity to 100% while not affecting specificity.

scholarly journals Acute ischaemic stroke secondary to a mobile thrombus in the common carotid artery - case report

2015 ◽  
Vol 1 (2) ◽  
pp. 68-70 ◽  
Author(s):  
Zoltán Bajkó ◽  
Smaranda Maier ◽  
Silvia Rusu ◽  
Anca Moțățăianu
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
Treatment Strategies ◽  
Duplex Ultrasound ◽  
Neurological Status ◽  
Heavy Smoker ◽  
Left Middle Cerebral Artery ◽  
Ischemic Attack ◽  
The Right

Abstract A mobile thrombus in the carotid arteries is a very rare ultrasonographic finding and is usually diagnosed after a neurological emergency, such as a transient ischemic attack or cerebral infarction. We present the case of a 54-year-old man with vascular risk factors (a heavy smoker, untreated hypertension) who was admitted to the emergency unit with right sided hemiparesis and aphasia. A cerebral CT scan showed a left middle cerebral artery territory infarction. The duplex ultrasound examination revealed mild atherosclerotic changes in the right common and internal carotid arteries, right-sided complete subclavian steal phenomenon and a complicated hypoechoic atherosclerotic plaque in the left common carotid artery with a large mobile thrombus. Due to the high embolization risk, the patient was hospitalised and prescribed Aspirin together with low molecular weight Heparin. We recorded an improvement in the patient’s neurological status and the control duplex scan revealed disappearance of the thrombus. The presence of floating thrombus in a patient with clinical and imagistic evidence of stroke is a major therapheutic challenge for the neurologist. The treatment strategies are not standardized and must be individualized, however in our case parenteral anticoagulation proved to be successful.

Evidence of carotid atherosclerosis in orthopantomograms and the risk for future cardiovascular events

VASA ◽  
2010 ◽  
Vol 39 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Hoke ◽  
Schmidt ◽  
Schillinger ◽  
Kluger ◽  
Wiesbauer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Cardiovascular Events ◽  
Carotid Atherosclerosis ◽  
Duplex Ultrasound ◽  
Major Adverse Cardiovascular Events ◽  
Clinical Consequence ◽  
Atherosclerotic Lesions ◽  
Intravascular Stents

Background: Evidence of carotid atherosclerosis can be detected in 3 to 5 % of orthopantomogram (OPG) investigations. The clinical impact of these findings is unknown. We investigated the association of OPG findings of carotid atherosclerosis with the occurrence of future cardiovascular adverse events. Patients and methods: We randomly selected 411 of 1268 participants with pre-existent cardiovascular disease from the prospective Inflammation in Carotid Arteries Risk for Arthrosclerosis Study (ICARAS) and assessed their OPGs for the presence of calcified atherosclerotic lesions or indirect signs of atherosclerosis, such as surgical clips or intravascular stents. The degree of carotid stenosis was measured by duplex ultrasound investigations. Patients were then followed for median 39 months (interquartile range 33 to 44 months) for the occurrence of major adverse cardiovascular events (MACE) including myocardial infarction, coronary revascularisation, stroke and death. Results: We found no statistically significant association between the presence of carotid atherosclerosis detected on OPGs and the presence of a significant carotid stenosis (left carotid artery kappa = 0.08; right carotid artery kappa = 0.12), or the degree of carotid stenosis (P = 0.20). Furthermore, the presence of OPG signs of carotid atherosclerosis was not statistically significant associated with future MACE (adjusted hazard ratio 0.92, 95 % confidence interval 0.59 to 1.42; P = 0.70). Conclusions: Evidence of carotid plaque revealed by OPGs in patients with previously known cardiovascular disease is no useful prognostic marker for MACE. Detection of carotid atherosclerosis by OPGs in these patients therefore has no clinical consequence.

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