Evaluation of carotid artery stenosis: is duplex ultrasonography sufficient?

Abstract

Purpose: The purpose of this study was to compare the results of duplex ultrasonography and magnetic resonance angiography in the evaluation of carotid artery stenosis to determine whether ultrasonography alone is sufficient for preoperative evaluation.

Methods: This study consisted of a retrospective review of 33 patients who underwent 35 carotid endarterectomies. A total of 66 vessels were studied by both duplex ultrasonography and magnetic resonance angiography, and an overall correlation between the two studies was determined.

Results: A high correlation was found between duplex and magnetic resonance angiography with an r coefficient equal to 0.87 (Pearson's correlation coefficient) and kappa = 0.75. Discrepancies between the two studies or the presence of intracranial disease did not alter surgical decision making.

Conclusion: Duplex ultrasonography alone can accurately determine the degree of internal carotid artery stenosis and when paired with careful clinical evaluation is a reliable and cost-effective method for evaluating surgical carotid disease.