Document Detail


Accuracy of duplex ultrasound in evaluating carotid artery anatomy before endarterectomy.
MedLine Citation:
PMID:  9510278     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Anatomic features, such as a high carotid bifurcation (< 1.5 cm from the angle of the mandible), excessive distal extent of plaque (> 2.0 cm above the carotid bifurcation), or a small diameter (< or = 0.5 cm) redundant or kinked internal carotid artery can complicate carotid endarterectomy. In the past, arteriography was the only preoperative study capable of imaging these features. This study assessed the ability of duplex ultrasound to evaluate their presence before surgery.
METHODS: A consecutive series of 20 patients who underwent 21 carotid endarterectomies had preoperative duplex ultrasound evaluations of these anatomic features. These evaluations were correlated with operative measurements from an observer blinded to the duplex findings.
RESULTS: The mean difference between duplex and operative measurements for the distance between the carotid bifurcation and the angle of the mandible, the distal extent of plaque, and the internal carotid artery diameter was 0.9 cm, 0.3 cm, and 0.8 mm, respectively. The correlation coefficient between the two methods was 0.86, 0.75, and 0.59, respectively. Duplex ultrasound predicted a high carotid bifurcation, excessive distal extent of plaque, or a redundant or kinked internal carotid artery with 100% sensitivity (p < 0.05, p < 0.01, and p < 0.001, respectively). The sensitivity of duplex ultrasound in predicting a small internal carotid artery diameter was 80%. The specificity of duplex ultrasound for predicting excessive distal extent of plaque, small internal carotid artery diameter, high carotid bifurcation, and a coiled or kinked carotid artery was 92%, 56%, 100%, and 100%, respectively.
CONCLUSION: Duplex ultrasound can predict the presence of anatomic features that may complicate carotid endarterectomy. Preoperative duplex imaging of these features may be helpful in patients who undergo carotid endarterectomy without preoperative arteriography.
Authors:
R A Wain; R T Lyon; F J Veith; G L Berdejo; J G Yuan; W D Suggs; T Ohki; L A Sanchez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  27     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-30     Completed Date:  1998-03-30     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  235-42; discussion 242-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, New York, NY 10467, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Artery, Internal / pathology,  ultrasonography
Carotid Stenosis / pathology,  surgery,  ultrasonography*
Endarterectomy, Carotid*
Female
Humans
Intracranial Arteriosclerosis / pathology,  surgery,  ultrasonography*
Male
Predictive Value of Tests
Preoperative Care
Sensitivity and Specificity
Ultrasonography, Doppler, Duplex*
Grant Support
ID/Acronym/Agency:
HL02990-03/HL/NHLBI NIH HHS

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