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Related Experiment Videos

Duplex sonography in patients with hemispheric symptoms.

B A Carroll1

  • 1Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|October 1, 1989
PubMed
Summary

Most patients experiencing hemispheric neurologic symptoms lack significant carotid artery stenosis. Duplex Doppler sonography effectively identifies patients needing further evaluation for carotid stenosis, aiding in treatment decisions.

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Area of Science:

  • Vascular Neurology
  • Diagnostic Imaging
  • Cerebrovascular Disease

Background:

  • Hemispheric neurologic symptoms often present without significant extracranial carotid artery stenosis.
  • Accurate assessment of carotid artery stenosis is crucial for managing patients with transient ischemic attacks (TIA), cerebrovascular accidents (CVA), and amaurosis fugax (AF).

Purpose of the Study:

  • To determine the frequency of operative carotid artery stenosis in patients presenting with hemispheric neurologic symptoms.
  • To evaluate the utility of duplex Doppler sonography as a primary diagnostic tool for identifying significant carotid stenosis.

Main Methods:

  • 154 patients with documented hemispheric events underwent duplex Doppler examinations of the extracranial carotid bifurcation.
  • Patient subgroups included those with TIA (n=72), CVA (n=62), and AF (n=20).

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  • Intra-arterial digital subtraction angiography (IADSA) was performed in a subset of patients (n=35) for comparison.

    • Main Results:

    • A majority of patients showed less than 50% stenosis: 69% in TIA, 52% in CVA, and 65% in AF.
    • Duplex Doppler sonography demonstrated high agreement with IADSA in identifying stenoses greater than 50% (35/35 cases).

    Conclusions:

    • Operative carotid artery stenosis is infrequent in patients with hemispheric neurologic symptoms.
    • Duplex Doppler sonography is a reliable triage procedure for identifying patients with significant carotid stenosis who may benefit from surgical intervention.