Carotid endarterectomy without angiography: Can clinical evaluation and duplex ultrasonographic scanning alone replace traditional arteriography for carotid surgery workup? A prospective study

摘要: Abstract Background: The aim of this study was to determine whether clinical evaluation and duplex ultrasonography (DUS) alone can replace contrast cerebral arteriography (CA) for the detection patients suitable surgery at our institution. Methods: During an 18-month period, 100 underwent DUS CA during carotid endarterectomy (CEA). All were studied prospectively; in each case initial decision or against CEA on basis internal arteries (ICAs) subsequently compared with surgeon's final management plan after CA. Of 200 ICAs evaluated, 113 considered but 14 excluded from because patient could not be evaluated before This left 99 (86 patients) available comparative analysis. Results: outcome 2 diagnostic modalities perfectly consistent 95.3% (κ = 0.969). altered by findings only cases (2%). suitable, 97 CEA. No arteriographic complications occurred among undergoing perioperative stroke risk mortality rates 0%. Conclusions: Ninety-eight percent would have received appropriate treatment strength patients' neurologic history alone. Our results indicate that is sufficient establish need symptomatic asymptomatic being most circumstances. (Surgery 1999;126:20-7.)