title: Carotid artery pseudo-occlusion: does end-diastolic velocity suggest need for treatment?
abstract: OBJECTIVE
  We reviewed our institution's experience with carotid artery pseudo-occlusion (CAPO), to investigate whether internal carotid artery (ICA) end-diastolic velocity (EDV) as measured by duplex ultrasonography, was a predictor of need for further intervention.
  
  
  METHODS
  From February 2003 to January 2008, 7478 patients underwent duplex ultrasonographic evaluation of their carotid arteries. Diagnosis of CAPO included the appearance of a narrow flow jet (string sign) on power doppler images, low velocities in the ICA and additional criteria listed below.
  
  
  RESULTS
  Ten patients (0.13%) were identified as having a CAPO. All patients were asymptomatic and had an EDV<78 cm/s. Occlusion or functional occlusion was identified in nine patients on contrast imaging studies. Eight of these patients were treated medically without neurologic complication on follow-up. Two patients were treated with interventions and were asymptomatic at follow up. The mean follow up for the entire group was 12 months.
  
  
  CONCLUSIONS
  Although this is a low volume study, there is evidence to suggest that asymptomatic patients with low EDV in the setting of carotid artery pseudo-occlusion found of duplex, may be safely managed medically.
authors.affiliation: Mount Sinai School of Medicine, Division of Vascular Surgery, New York, NY 10029, USA. Jonathan.Bowman@mssm.edu
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Bowman
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Olin
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Teodorescu
authors.forename: Alfio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Sharif H
authors.initials: SH
authors.lastname: Ellozy
authors.forename: Michael L
authors.initials: ML
authors.lastname: Marin
authors.forename: Peter L
authors.initials: PL
authors.lastname: Faries
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012039:Regional Blood Flow; D012189:Retrospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color