Ultrasonographic and perioperative macroscopic findings in acute carotid artery occlusion.
OBJECTIVE
acute ischemic stroke (AIS) may occur both in the acute and chronic internal carotid artery occlusion (ICAo). Thus, it is important to assess the ICAo character when considering the recanalization method. The aim was to assess the agreement between the ultrasonographic (US) and perioperative macroscopic (PM) finding in AIS patients with acute ICAo, undergoing an emergent carotid endarterectomy.


METHODS
in a retrospective, hospital-based study, the set consisted of 47 patients (36 males; age 49-79, mean 63.7 ± 8.5 years). ICAo character was classified as an acute thromboembolus either isolated or in combination with atherosclerotic plaque using the US (B-mode) and the PM evaluation. Cohen's Kappa and AC(1) coefficient were applied to assess the methods agreement.


RESULTS
an acute ICAo character diagnosed by US was confirmed by the PM evaluation in all cases. US and PM findings were consistent in 41 cases. The agreement between both methods in the classification of acute ICAo was 87.2% [95% confidence interval (CI): 77.7-96.8%], κ= .589 (95% CI: .293-.885) (P < .0001), AC(1) = .815.


CONCLUSIONS
US is a reliable method in the diagnostics of the acute character of ICAo and it has a good agreement with PM finding regarding a differentiation of atherosclerotic plaque and fresh thromboembolus.
Herzig
Roman
R
Stroke Center, Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic.
Skoloudík
David
D
Král
Michal
M
Saňák
Daniel
D
Roubec
Martin
M
Skoda
Ondřej
O
Bachleda
Petr
P
Utíkal
Petr
P
Havránek
Pavel
P
Hrbáč
Tomáš
T
Fučík
Milan
M
Dvořáčková
Jana
J
Zapletalová
Jana
J
Hluštík
Petr
P
Bar
Michal
M
Kaňovský
Petr
P
D000368:Aged; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013923:Thromboembolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography