title: Bedside screening with the use of pocket-size imaging device can be useful for ruling out carotid artery stenosis in patients scheduled for cardiac surgery.
abstract: BACKGROUND
  Patients (pts) scheduled for coronary artery bypass grafting, burdened with high risk of carotid stenosis, are recommended to undergo duplex ultrasonography (DUS) of carotid arteries.
  
  
  OBJECTIVE
  To validate pocket-size imaging device (PSID) equipped with linear probe as an easily accessible tool enabling bedside screening for carotid artery stenosis (CAS).
  
  
  METHODS
  A total of 100 pts (60 men, mean age 69±11 years) with multivessel coronary artery disease underwent bedside DUS of carotid arteries with the use of PSID performed by a cardiology resident trained in DUS. Subsequently, DUS with the use of stationary high-end ultrasound system was performed in all pts to verify findings of PSID examination.
  
  
  RESULTS
  Initial diagnosis of atherosclerotic plaque presence obtained with PSID in 59 patients was confirmed by high-end ultrasound system examination in all cases. There was a statistically significant correlation of intima-media thickness measurements between PSID and stationary system (r=.58; 95% CI: 0.48-0.66; P<.0001), but the coefficient of agreement (κ) between the two methods in classification of intima-media as normal or thickened (>0.9 mm) was only .38 (95% CI: 0.299-0.459). During PSID examination, turbulent flow was observed in 21 pts-CAS was confirmed in all these pts-5 pts were diagnosed with significant CAS, the rest with CAS ranging from 30% to 70%.
  
  
  CONCLUSIONS
  Pocket-size imaging device equipped with linear probe allows for identification of patients with atherosclerotic plaques and turbulent flow in carotid arteries; however, the degree of CAS cannot be reliably determined. The measurement accuracy of intima-media thickness is insufficient for a diagnostic purpose.
authors.affiliation: Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Dominika
authors.identifier: http://orcid.org/0000-0001-5760-1243
authors.initials: D
authors.lastname: Filipiak-Strzecka
authors.affiliation: Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Jarosław D
authors.initials: JD
authors.lastname: Kasprzak
authors.affiliation: Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Szymczyk
authors.affiliation: Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Wejner-Mik
authors.affiliation: Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lipiec
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D008904:Miniaturization; D000067716:Point-of-Care Testing; D011300:Preoperative Care / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: carotid artery; coronary artery bypass graft surgery; hand-carried ultrasound