Variability of Doppler Velocity Ratios as a Function of Location in the Common Carotid Artery: Potential Problems When Quantifying Significant Internal Carotid Artery Stenoses

Authors: Scissons R.P.; Gillis J.C.; Patterson R.B.; Weyman A.K.

Source: Journal for Vascular Ultrasound, Volume 27, Number 1, 1 March 2003 , pp. 16-19(4)

Publisher: Society for Vascular Ultrasound

Buy & download fulltext article:

OR

Price: $28.00 plus tax (Refund Policy)

Abstract:

Introduction.—The use of the internal carotid artery (ICA) to common carotid artery (CCA) peak systolic velocity ratio (ICApsv/CCApsv) to quantitate ICA stenosis has been challenged based on the variability of Doppler-derived velocities at various locations within the CCA. We investigated these alleged differences to determine whether they affect actual classification of significant ICA stenoses.

Methods.—Data from consecutive patients for an 18-month period were prospectively entered into a database. Only initial studies were included in this investigation. Follow-up examinations, postendarterectomy vessels, ICA occlusions, and CCA vessels with a PSV of >150 cm/sec were excluded from analysis. CCApsv and ICApsv/CCApsv were obtained and based on Doppler analysis at both the proximal most visualized CCA segment (proximal), and 1.5 cm proximal to the ICA flow divider (distal). ICApsv/CCApsv values of ge 2, ge 3, and ge 4 were used as threshold values for ge 50%, ge 60%, and ge 70% diameter stenoses.

Results.—A total of 383 patients and 588 vessels were analyzed. CCApsv-proximal values, 75 ± 20 cm/sec, were significantly higher than CCApsv-distal, 68 ± 16 cm/sec (p < 0.001). ICApsv/ CCApsv-distal ratios, 2.36 ± 2.77, were significantly higher than ICApsv/CCApsv-proximal, 2.11 ± 2.46, (p < 0.001). The average absolute difference between CCApsv-proximal and CCApsv-distal was 15% ± 13% (range, 0%–93%). For an ICApsv/CCApsv ge 50%, proximal and distal ratios would both be < 2 in 66%, ge 2 in 29%, and 5% were contradictory. For an ICApsv/CCApsv ge 60%, proximal and distal ratios would both be < 3 in 78%, ge 3 in 18%, and 4% contradictory. For an ICApsv/CCApsv ge 70%, proximal and distal ratios would both be < 4 in 85%, ge 4 in 12%, and in 3% contradictory.

Conclusions.—Significant differences in ICApsv/CCApsv calculation as a function of location of the CCApsv measurement were confirmed. Proximal and distal sampling sites, however, did not affect ICApsv/CCApsv classifications for 95% of the vessels analyzed. For contradictory classifications, ICApsv/CCApsv-distal had more potential for a positive result. To improve accuracy and address sensitivity or specificity interpretation parameters, the influence of the CCA sampling site should be considered and standardized when using carotid ratio criteria.

Document Type: Research article

Publication date: 2003-03-01

More about this publication?
  • The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.

    Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • Membership Information
  • Information for Advertisers
  • Reprints
  • ingentaconnect is not responsible for the content or availability of external websites
Related content

Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content

Text size:

A | A | A | A
Share this item with others: These icons link to social bookmarking sites where readers can share and discover new web pages. print icon Print this page