Prospective evaluation of new duplex criteria to identify 70% internal carotid artery stenosis

摘要: Abstract Purpose: Large multicenter trials (North American Symptomatic Carotid Endarterectomy Trial, European Surgery Trial) have documented the benefits of carotid endarterectomy for treating symptomatic patients with ≥ 70% stenosis internal artery. Although color-flow duplex scanning has become preferred method noninvasive assessment artery disease, no criteria been generally accepted to identify this subset patients. We previously reported a retrospective series establish such criteria. This study details our results when these were applied prospectively. Methods: scans compared arteriograms in 457 who underwent both studies. Criteria peak systolic velocity >130 cm/sec and end-diastolic >100 cm/sec. Internal arteries Results: was detected sensitivity 87%, specificity 97%, positive predictive value 89%, negative 96%, overall accuracy 95%. Eighty-seven percent 99% stenoses correctly identified. False-positive errors (n = 10) attributed contralateral occlusion or high-grade (>90%) 5) interpreter error 1); explanation apparent other four. Eleven 12 false-negative examinations occurred 80% stenosis. Conclusions: In laboratories, prospective application above identified ≥70% reasonably high degree accuracy. Errors borderline severe disease. With suitably modified criteria, remains most reliable identifying are candidates endarterectomy. (J V ASC S URG 1996;23:254-62.)