Rapid Carotid Screening by Duplex: A Prospective Single Centre Assessment.

Area of Science:

• Vascular Medicine
• Medical Imaging
• Diagnostic Ultrasound

Background:

• Carotid atherosclerosis screening is crucial for preventing stroke.
• Conventional duplex ultrasound protocols can be time-consuming in busy vascular outpatient settings.
• A need exists for a faster, accurate screening tool for significant carotid stenosis.

Purpose of the Study:

• To develop and assess the accuracy and efficiency of a novel Carotid Quick Scan (CQS) protocol.
• To evaluate the CQS for rapid screening of >50% carotid stenosis in a vascular outpatient environment.
• To determine the time saved by using the CQS compared to a full carotid duplex study.

Main Methods:

• The Carotid Quick Scan (CQS) protocol was developed using a modified Delphi technique by vascular surgeons and scientists.
• The CQS involves a rapid B-mode and color flow sweep of carotid arteries with velocity assessment.
• Accuracy was evaluated against conventional full carotid duplex studies in 100 outpatients with peripheral artery disease or abdominal aortic aneurysm.

Main Results:

• The CQS demonstrated high accuracy (96.5%) in detecting >50% carotid stenosis (Cohen's ƙ = .88).
• Sensitivity was 91.4% and specificity was 97.6%, with a negative predictive value of 98.2%.
• Median CQS time was significantly shorter (13 seconds/side) compared to full duplex (151 seconds/side), with substantial time savings in patients with significant disease.

Conclusions:

• The Carotid Quick Scan (CQS) is a rapid and accurate tool for screening carotid atherosclerosis.
• The protocol is acceptable to patients and healthcare professionals.
• Widespread adoption of CQS in vascular laboratories can reduce the time and cost associated with excluding significant carotid disease.