Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2011 Jul 13:11:44.
doi: 10.1186/1471-2261-11-44.

Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

Elias P Johansson  1 , Jan Ahlqvist, Maria Garoff, Kjell Karp, Eva Levring Jäghagen, Per Wester
Affiliations
Clinical Trial

Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

Elias P Johansson et al. BMC Cardiovasc Disord. .

Abstract

Background: Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications.

Methods: This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy.

Results: Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5%) had a carotid stenosis--not significant over the 5% pre-specified threshold (p = 0.232, Binomial test). However, there was a significant sex difference (p = 0.008), as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8%) had carotid stenosis--significantly over the 5% pre-specified threshold (p = 0.014, Binomial test).

Conclusions: The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy.

Trial registration: The study was registered at http://www.clinicaltrials.gov; NCT00514644.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Panoramic image. Showing bilateral calcification in the area of the carotid arteries (arrows). (M = mandible, CS = cervical spine, HB = hyoid bone).
Figure 2
Figure 2
Anterio-posterior projection of the neck. Showing calcifications in the area of the carotid arteries (arrows) adjacent to the cervical spine.
Figure 3
Figure 3
Trial profile.
Figure 4
Figure 4
Reasons for reference persons to be excluded from the study.
See this image and copyright information in PMC

References

    1. Chambers BR, Donnan GA. Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database of Systematic Reviews. 2005;4:CD001923. - PMC - PubMed
    1. Halliday A, Harrison M, Hayter E, Kong X, Mansfield A, Marro J, Pan H, Peto R, Potter J, Rahimi K, Rau A, Robertson S, Streifler J, Thomas D. on behalf of the Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet. 2010;376:1074–1084. doi: 10.1016/S0140-6736(10)61197-X. - DOI - PMC - PubMed
    1. Abbott AL. Medical (Nonsurgical) Intervention Alone Is Now Best for Prevention of Stroke Associated With Asymptomatic Severe Carotid Stenosis Stroke. Stroke. 2009;40:e573–e583. doi: 10.1161/STROKEAHA.109.556068. - DOI - PubMed
    1. The ESO Guidelines. http://www.eso-stroke.org/recommendations.php
    1. Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, Cates CU, Creager MA, Fowler SB, Friday G, Hertzberg VS, McIff EB, Moore WS, Panagos PD, Riles TS, Rosenwasser RH, Taylor AJ. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. JACC. 2011;57:e16–94. - PubMed

Publication types

Associated data