Accuracy of duplex sonography before carotid endarterectomy — A comparison with angiography

• Published in: European journal of vascular and endovascular surgery Vol. 12; no. 3; pp. 331 - 336
• Main Authors: Hansen, F., Bergqvist, D., Lindblad, B., Lindh, M., Mätzsch, T., Länne, T.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-1996
• Subjects: Aged; Aged, 80 and over; Angiography, Digital Subtraction; Blood Flow Velocity; Carotid angiography; Carotid Arteries - diagnostic imaging; Carotid artery; Carotid artery stenosis; Carotid Artery, Internal - diagnostic imaging; Carotid Stenosis - diagnostic imaging; Clinical Medicine; Doppler; Duplex sonography; Endarterectomy, Carotid; Evaluation Studies as Topic; Female; Humans; Image Enhancement; Kirurgi; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Preoperative Care; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Surgery; Ultrasonography, Doppler, Duplex; Carotid angiography; Carotid artery; Duplex sonography; Carotid artery stenosis; Doppler
• ISSN: 1078-5884; 1532-2165; 1532-2165
• DOI: 10.1016/S1078-5884(96)80252-8

The aim of this prospective study was to contribute to the evaluation of the reliability of Duplex sonography (DS) before carotid endarterectomy (CEA).
The study was performed prospectively in a university hospital setting.
Eighty-one consecutive patients aged 49–83 years were examined with DS and carotid angiography (CAG) before CEA. The results of the DS were judged as either confident, or CAG was assessed to be necessary preoperatively. The results from the DS and the CAG were then compared.
DS was judged as confident in 148 of the 162 arteries examined. In none of these 148 arteries did CAG change patient management in any way, and the agreement between DS and CAG was good. In the remaining 14 arteries CAG was judged necessary, in 11 arteries because DS assessed the internal carotid artery (ICA) as occluded, which was confirmed by CAG in 10 arteries. In three arteries the reason was poor quality of the DS, however these three arteries were correctly assessed as severely diseased.
This study confirms that DS alone is sufficient in the preoperative evaluation before CEA, provided that CAG is performed whenever DS shows occlusion of the ICA, or when the quality of the DS is poor.