title: Ultrasonographic and perioperative macroscopic findings in acute carotid artery occlusion.
abstract: 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.
authors.affiliation: Stroke Center, Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Herzig
authors.forename: David
authors.initials: D
authors.lastname: Skoloudík
authors.forename: Michal
authors.initials: M
authors.lastname: Král
authors.forename: Daniel
authors.initials: D
authors.lastname: Saňák
authors.forename: Martin
authors.initials: M
authors.lastname: Roubec
authors.forename: Ondřej
authors.initials: O
authors.lastname: Skoda
authors.forename: Petr
authors.initials: P
authors.lastname: Bachleda
authors.forename: Petr
authors.initials: P
authors.lastname: Utíkal
authors.forename: Pavel
authors.initials: P
authors.lastname: Havránek
authors.forename: Tomáš
authors.initials: T
authors.lastname: Hrbáč
authors.forename: Milan
authors.initials: M
authors.lastname: Fučík
authors.forename: Jana
authors.initials: J
authors.lastname: Dvořáčková
authors.forename: Jana
authors.initials: J
authors.lastname: Zapletalová
authors.forename: Petr
authors.initials: P
authors.lastname: Hluštík
authors.forename: Michal
authors.initials: M
authors.lastname: Bar
authors.forename: Petr
authors.initials: P
authors.lastname: Kaňovský
mesh_terms: 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