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Related Experiment Videos

Normal angiograms and carotid pathology.

J Senkowsky1, W H Bell, M D Kerstein

  • 1Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.

The American Surgeon
|November 1, 1990
PubMed
Summary

B-mode ultrasound better identifies non-stenotic ulcerative carotid plaques than traditional angiography. This imaging may guide carotid endarterectomy decisions, potentially reducing the need for invasive angiograms in symptomatic patients.

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Area of Science:

  • Vascular Surgery
  • Diagnostic Imaging
  • Neurology

Background:

  • Non-stenotic ulcerated atherosclerotic plaques in carotid arteries can cause transient ischemic attacks (TIAs) and stroke.
  • Traditional preoperative evaluation involves ultrasound and arch aortography.
  • Emerging evidence suggests ultrasound's superior accuracy in detecting non-stenotic lesions.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of B-mode ultrasound compared to arteriography in identifying non-stenotic ulcerative carotid plaques.
  • To assess the utility of ultrasound findings in guiding surgical decisions for carotid endarterectomy.

Main Methods:

  • Retrospective analysis of 21 patients with symptoms of hemispheric TIAs.
  • All patients underwent both B-mode ultrasound and arteriography.
  • Surgical confirmation of ultrasound findings was obtained for all patients.

Main Results:

  • Ultrasound detected ulcerative disease in all 21 patients, while arteriograms were initially interpreted as negative.
  • Operative findings confirmed 20-50% stenosis and ulcerative plaques in these patients.
  • Retrospective review of arteriograms identified only three ulcerations.

Conclusions:

  • B-mode ultrasound is more effective than arteriography in defining non-stenotic ulcerative carotid lesions.
  • Positive ultrasound findings, coupled with relevant symptoms, may suffice for carotid endarterectomy decisions, potentially obviating the need for angiography.

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