Comparison of carotid artery dimensions and lesion length measured by B‐mode ultrasonography and quantitative angiography in patients with severe stenosis undergoing percutaneous revascularization

BACKGROUND: To evaluate the correlation and agreement of the carotid artery landmarks necessary for carotid artery stenting obtained by B-mode ultrasonography (BMU), and by quantitative angiography (QCA) in patients with severe carotid artery stenosis. METHODS: In 75 patients undergoing carotid artery stenting, the distal common (CCA), proximal internal (ICA) carotid artery diameter, and lesion length were measured preoperatively by BMU, and intraoperatively by QCA. RESULTS: In 96% of the subjects, BMU imaging was adequate for interpretation. BMU and QCA Pearson correlation and Lin concordance coefficients were 0.75 (p < 0.001) and 0.959 (95% CI: 0.930 - 0.996), respectively, for CCA diameter, 0.88 (p < 0.001) and 0.954 (95% CI: 0.928-0.983), respectively, for ICA diameter, and 0.62 (p < 0.001) and 0.734 (95% CI: 0.719-0.760), respectively, for lesion length, with a 0.765 bias correction factor and a wider data scatter by Bland Altman plots showing shorter lesion length by BMU than by QCA. CONCLUSIONS: In patients with carotid artery stenosis, BMU can provide reliable distal CCA and proximal ICA diameters in comparison with QCA, whereas lesion length measured by BMU has an acceptable correlation, but a poor agreement with QCA.