Sensitivity and specificity of color duplex ultrasound measurement in the estimation of internal carotid artery stenosis: A systematic review and meta-analysis

Jahromi, Afshin S.; Cinà, Claudio S.; Liu, Yan; Clase, Catherine M.

doi:10.1016/j.jvs.2005.02.044

Cited by 263 publications

(185 citation statements)

References 64 publications

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“…The authors found that carotid duplex ultrasonography had an estimated sensitivity of 86% and a specificity of 87% for detecting carotid artery stenosis of 70%-99%. 54 In a meta-analysis by Jahromi and colleagues, 29 the authors reported comparable results for sensitivity and specificity. Using their analysis, a sensitivity of 94% was estimated, as was a specificity of 92% for carotid artery stenosis of 60% or greater.…”

Section: Diagnostic Studiesmentioning

confidence: 95%

“…Using their analysis, a sensitivity of 94% was estimated, as was a specificity of 92% for carotid artery stenosis of 60% or greater. 29,72 The reliability of carotid artery duplex ultrasonography, however, has significant limitations with important differences in the measurement properties applied by different ultrasound laboratories, which may result in clinically relevant differences.…”

Section: Diagnostic Studiesmentioning

confidence: 99%

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Clinical considerations in the management of asymptomatic carotid artery stenosis

Taussky

Hanel

Meyer

2011

FOC

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Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options according to their individual risk profile and according to professionals' knowledge of evidence-based data derived from large randomized control trials. Treatment consensus has long been lacking for patients with asymptomatic carotid artery stenosis prior to any randomized controlled trials. Additionally, an individual's risk profile may be hard to assess according to knowledge gained from randomized controlled trials. Moreover, while earlier studies compared carotid endarterectomy and medical therapy, in the past years, a new therapeutic modality, carotid artery angioplasty and stenting, has emerged as a possible alternative. This has been evaluated in a recent randomized controlled trial, the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), which compared carotid endarterectomy with angioplasty and stenting in both symptomatic and asymptomatic patients. The following review summarizes current knowledge of the natural history, diagnosis, and treatment strategies to counsel patients with asymptomatic carotid artery stenosis.

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Section: Diagnostic Studiesmentioning

confidence: 95%

Section: Diagnostic Studiesmentioning

confidence: 99%

Clinical considerations in the management of asymptomatic carotid artery stenosis

Taussky

Hanel

Meyer

2011

FOC

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“…The evaluation therefore contains information regarding stenosis morphology as well as information regarding the flow velocity measured in cm per second, the peak systolic velocity (PSV) and the end diastolic velocity (EDV) being the most prominent parameters. According to the current literature, a PSV of > 130 cm/sec will be found in more than 50 % of cases of ICA stenosis, whereas a PSV of > 250 cm/ sec and end diastolic velocity of > 120 cm/sec describe more than 70 % of cases of stenosis [61]. Since color-coded duplex ultrasound and spectrum analysis are particularly dependent on the experience of the examiner and the angle of the ultrasound probe, there is a trend toward using alternative methods for stenosis grading in the clinical routine.…”

Section: Color-coded Duplex Sonography For Graduation Of Stenosismentioning

confidence: 98%

“…It is currently indisputable that the accurate grading of internal carotid stenosis can be reliably done by means of ultrasound. There are several studies in which ultrasound has reached excellent sensitivity and specificity values for this purpose as compared to other methods [30]. For exact stenosis quantification, a combination of B-mode imaging, the superimposed color-coded duplex analysis and analysis of the derived Doppler spectrum is used [31] (• ▶ Fig.…”

Section: Color-coded Duplex Sonography For Graduation Of Stenosismentioning

confidence: 99%

Current Strategies and Possible Perspectives of Ultrasonic Risk Stratification of Ischemic Stroke in Internal Carotid Artery Disease

Eyding

Geier

Staub³

2010

Ultraschall in Med

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“…O seguimento no pós-operatório da ECA associado ao avanço e ao uso mais abrangente dos testes diagnósticos não invasivos, em especial a ultrassonografia com Doppler, proporcionou um aumento no número de diagnóstico de pacientes portadores de reestenose da artéria carótida pós-endarterectomia 3 .…”

Section: Introductionunclassified

Tratamento endovascular da reestenose carotídea: resultados em curto prazo

Lujan¹,

Lucas²,

Gracio³

et al. 2011

J. vasc. bras.

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ResumoContexto: O tratamento cirúrgico da reestenose carotídea apresenta alta taxa de lesão neurológica. Contrariamente, o tratamento endovascular da doença obstrutiva carotídea extracraniana tem se tornado mais factível e gradualmente menores taxas de risco cirúrgico vêm sendo reportadas, tornando-se uma opção em situações especiais, e provavelmente poderá ser considerado o tratamento padrão para reestenose carotídea. Objetivos: Avaliar a aplicabilidade, a segurança e a eficácia da angioplastia com o uso do stent (ACS) no tratamento da reestenose carotídea (REC) no intraoperatório e no pós-operatório recente (<30 dias). Métodos: Análise retrospectiva dos pacientes portadores de reestenose carotídea submetidos à angioplastia com stent no período de março 2000 a junho de 2004. Resultados: Foram analisados 19 pacientes com reestenose carotídea. Quatorze pacientes (74%) eram do sexo masculino, com média de idade de 74 anos. Quinze (79%) eram assintomáticos com estenose >80%, enquanto quatro (21%) eram sintomáticos com estenose >70%. Apenas em um paciente não foi utilizado sistema de proteção cerebral. O sucesso técnico foi obtido em todos os casos. Não houve morte ou acidente vascular encefálico no intra ou no pós-operatório recente (30 dias). Conclusão: O tratamento endovascular da reestenose carotídea mostrou-se uma abordagem factível e segura em curto prazo.Palavras-chave: Doenças das artérias carótidas; angioplastia com balão; estenose das carótidas. AbstractContext: The surgical treatment of carotid artery restenosis presents a high risk of nerve injury. On the contrary, endovascular treatment for extracranial carotid artery obstructive disease has become more feasible. Gradually, lower rates of surgical risk have been reported, which makes the treatment a good option in special situations. It may be considered as the standard treatment for carotid artery restenosis. Objective: To evaluate the applicability, safety, and efficacy of the angioplasty with the use of a stent (Carotid Artery Stenting -CAS) for the treatment of carotid artery restenosis, in the intraoperative and early (<30 days) postoperative period. Methods: Retrospective analysis of patients with carotid artery restenosis who have undergone stenting angioplasty from March 2000 to June 2004. Results: Nineteen patients with carotid artery restenosis were analyzed. Fourteen (74%) patients were male, with a mean age of 74 years. Fifteen (79%) patients were asymptomatic, with stenosis >80%, whereas 4 (21%) were symptomatic with stenosis >70%. In only one patient a cerebral protection system was not used. Technical success was achieved in all cases. There was no death or stroke in the intraoperative or the early postoperative period (30 days). Conclusion: Endovascular treatment of carotid artery restenosis seems to be a feasible and safe approach in the short term.

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Sensitivity and specificity of color duplex ultrasound measurement in the estimation of internal carotid artery stenosis: A systematic review and meta-analysis

Abstract: Clinicians need to be aware of the limitations of duplex ultrasound scanning when making management decisions.

Cited by 263 publications

References 64 publications

Clinical considerations in the management of asymptomatic carotid artery stenosis

Clinical considerations in the management of asymptomatic carotid artery stenosis

Current Strategies and Possible Perspectives of Ultrasonic Risk Stratification of Ischemic Stroke in Internal Carotid Artery Disease

Tratamento endovascular da reestenose carotídea: resultados em curto prazo

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