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Abstract Background The European Society for Vascular Surgery (ESVS) carotid guidelines recommend the use of duplex ultrasound (DUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in assessing carotid stenosis. ESVS recommends corroborating DUS estimates with a CTA, MRA or a repeat DUS with ideally a second operator. Method In this retrospective cohort study of 73 consecutive carotid endarterectomy patients (between June 2022 and June 2023), data were collected from the Picture Archiving Communications System which included the date of each investigation and quantification of the degree of carotid stenosis based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method. Spearman’s rank correlation coefficient was used to evaluate the correlation between DUS and CTA estimates of carotid stenosis. Results 71 symptomatic and 2 asymptomatic CEAs were conducted. Among these, 69.9% (n=51) underwent DUS followed by a CTA, 8.2% (n=6) had a CTA preceding DUS, 1.4% (n=1) underwent sequential DUS, CTA and MRA, 8.2% (n=6) received two DUS scans, with 5 conducted by a different operator and 12.3% (n=9) had only a single DUS. For the 57 patients with both DUS and CTA, in any order, a statistically significant, positive correlation was observed (r= 0.514, 95% CI 0.3075 – 0.7135, p0.0001). Conclusions The imaging strategies recommended by the ESVS are being undertaken in the majority of patients. Only 12.3% of patients did not have a corroborating scan undertaken. Despite the acknowledged operator dependence of DUS, this study found a strong positive correlation with CTA estimates of carotid stenosis.
Musa et al. (Mon,) studied this question.