Carotid stenosis in the real world--can Doppler ultrasound replace angiography in a district general hospital setting?
Large trials have confirmed the benefit of carotid endarterectomy in the prevention of stroke in patients with transient ischaemic attacks and > or =70% stenosis of the ipsilateral internal carotid artery. Invasive confirmatory angiography carries some risk, but these patients can be identified by Doppler ultrasound. Non-invasive confirmatory testing with spiral computed tomographic angiography or magnetic resonance angiography is not easily available in many hospitals. In this study, criteria have been developed for use in this unit to identify significant carotid artery stenosis and enable selection for surgery after Doppler ultrasound alone, with known degrees of sensitivity, specificity and accuracy. Carotid arteriography is reserved for a minority of cases.
Orgles
C S
CS
Department of Radiology, Bradford Royal Infirmary, UK.
Chakraverty
S
S
Gopichandran
T D
TD
D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*