Noninvasive diagnosis of internal carotid artery occlusion

Sullivan, Eugene D.; Cranley, John J.

doi:10.1016/0002-9610(83)90291-x

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…If one calculates from these data the positive predictive value of ultrasound imaging in making a diagnosis of occlusion, the values range widely-from 58% to 100%. [1][2][3][4][5][6][7][8] Making the distinction between occlusion and high-grade stenosis, however, is clinically important. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) has shown that carotid endarterectomy for high-grade symptomatic carotid artery stenosis (70% to 99%) is highly effective in preventing ipsilateral stroke and can be safe.…”

Section: Discussionmentioning

confidence: 99%

Carotid artery occlusion: Positive predictive value of duplex sonography compared with arteriography

Kirsch¹,

Wagner²,

James³

et al. 1994

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Carotid artery occlusion: Positive predictive value of duplex sonography compared with arteriography

Kirsch¹,

Wagner²,

James³

et al. 1994

Journal of Vascular Surgery

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“…The literature search process is detailed in a PRISMA flow diagram (Figure 1). [32,33], two used colour-flow Duplex US [42,43], two used Doppler US [23,34], and another one used high-and low-frequency US [35].…”

Section: Results Of the Searchmentioning

confidence: 99%

“…We performed sensitivity analysis removing the two studies that used B-mode US as the index test [32,33]. The pooled sensitivity and sensitivity were 0.98 (95% CI 0.95 to 0.99) and 0.99 (95% CI 0.98 to 1.00), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, in the study of Paciarioni et al [39], one of the false negative results could be attributed to the fact that arteriography was performed 3.5 months after US, and hence a near-occlusion could have progressed to complete occlusion during that time. In the study of Sullivan et al [32], the 6-week delay between the index test and reference standard was said to be a potential reason for the false negatives. Another factor identified by Mattos et al [34] was the accuracy of user interpretation.…”

Section: Methodological Quality Of Included Studiesmentioning

confidence: 99%

“…The reference standard in the included studies were cut-film technique or DSA used by six studies [29,34,38,41,42,47], DSA used by 11 studies [16,23,31,33,35,37,39,40,43,44,46], cerebral arteriography used by two studies [27,36], percutaneous catheter angiography used by one study [45], biplanar carotid arteriography used by one study [32], and carotid endarterectomy, used by two studies [28,30].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Ultrasonography for the diagnosis of extra-cranial carotid occlusion – diagnostic test accuracy meta-analysis

Rojoa

Lodhi

Kontopodis

et al. 2020

Vasa

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Summary: Background: The correct diagnosis of internal carotid artery (ICA) occlusion is crucial as it limits unnecessary intervention, whereas correct identification of patients with severe ICA stenosis is paramount in decision making and selecting patients who would benefit from intervention. We aimed to evaluate the accuracy of ultrasonography (US) in the diagnosis of ICA occlusion. Methods: We conducted a systematic review in compliance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) of diagnostic test accuracy studies. We interrogated electronic bibliographic sources using a combination of free text and thesaurus terms to identify studies assessing the diagnostic accuracy of US in ICA occlusion. We used a mixed-effects logistic regression bivariate model to estimate summary sensitivity and specificity. We developed hierarchical summary receiver operating characteristic (HSROC) curves. Results: We identified 23 studies reporting a total of 5,675 arteries of which 722 were proven to be occluded by the reference standard. The reference standard was digital subtraction or cerebral angiography in all but two studies, which used surgery to ascertain a carotid occlusion. The pooled estimates for sensitivity and specificity were 0.97 (95% confidence interval (CI) 0.94 to 0.99) and 0.99 (95% CI 0.98 to 1.00), respectively. The diagnostic odds ratio was 3,846.15 (95% CI 1,375.74 to 10,752.65). The positive and negative likelihood ratio were 114.71 (95% CI 58.84 to 223.63) and 0.03 (95% CI 0.01 to 0.06), respectively. Conclusions: US is a reliable and accurate method in diagnosing ICA occlusion. US can be used as a screening tool with cross-sectional imaging being reserved for ambiguous cases.

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Analysis of blood clot echogenicity

Peter

Flanagan

Cranley

1986

J of Clinical Ultrasound

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The ability of B-mode ultrasound to follow effectively blood clot echogenicity changes over time under conditions of red cell preservation and lysis was evaluated. Blood clots were produced in cellulose dialysis tubing and then placed into appropriate baths of either saline or water. The echogenicity changes were then followed quantitatively using A-mode and qualitatively using B-mode imaging. Blood clots in saline showed an initial decrease followed by a leveling off in echogenicity. Blood clots in water showed a decline in echogenicity throughout the experiment. The A-mode imaging was effectively able to follow blood clot echogenicity changes under these controlled conditions.

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Noninvasive diagnosis of internal carotid artery occlusion

Cited by 8 publications

References 11 publications

Carotid artery occlusion: Positive predictive value of duplex sonography compared with arteriography

Carotid artery occlusion: Positive predictive value of duplex sonography compared with arteriography

Ultrasonography for the diagnosis of extra-cranial carotid occlusion – diagnostic test accuracy meta-analysis

Analysis of blood clot echogenicity

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