Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(3):255-260 | DOI: 10.5507/bp.2019.029

Diagnostic criteria for the determination of clinically significant internal carotid artery stenosis using duplex ultrasound

Karel Goricana, Miroslav Chocholab, Miroslav Kocika, Ales Zak
a 4th Department of Internal Medicine, First Faculty of Medicine, Charles University in Prague and General Teaching Hospital in Prague, Prague, Czech Republic
b 2nd Department of Internal Medicine, First Faculty of Medicine, Charles University in Prague and General Teaching Hospital in Prague, Prague, Czech Republic

Background: Carotid endarterectomy is beneficial in symptomatic patients with ≥70% stenosis at the bifurcation of the internal carotid artery. The fact that the duplex ultrasound is widely used, inexpensive and non-invasive for examination of the carotid arteries underlines the importance of high accuracy of this method for grading internal artery stenosis.

Patients and Methods: Duplex scans and arteriograms of carotid arteries of 142 patients were reviewed. Peak and end-diastolic velocities of the common and internal carotid arteries were recorded, and the percent stenosis of the internal carotid artery was determined by arteriogram. Receiver-operator characteristic curves of sensitivity, specificity, positive and negative predictive values and accuracy were determined.

Results: The recommended criteria for the detection of ≥70% stenosis of the internal carotid artery were: peak systolic velocity in the internal carotid artery ≥215 cm/s, end-diastolic velocity in the internal carotid artery ≥65 cm/s, ratio of peak systolic velocities in the internal and common carotid arteries ≥2.7 and ratio of the end-diastolic velocities of the internal and common carotid arteries ≥3.7.

Conclusion: These criteria allow for reliable determination of internal carotid artery stenosis ≥70% by duplex ultrasound.

Keywords: carotid stenosis, diagnosis, duplex ultrasound, extracranial occlusive disease

Received: February 23, 2019; Revised: May 14, 2019; Accepted: June 3, 2019; Prepublished online: June 17, 2019; Published: September 17, 2020  Show citation

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Gorican, K., Chochola, M., Kocik, M., & Zak, A. (2020). Diagnostic criteria for the determination of clinically significant internal carotid artery stenosis using duplex ultrasound. Biomedical papers, 164(3), 255-260. doi: 10.5507/bp.2019.029
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