What question did this study set out to answer?

To evaluate the clinical factors associated with Doppler ultrasound errors when distinguishing between total occlusion and near-total occlusion of the internal carotid artery.

May 1, 1989StrokeOpen Access

Clinical correlates of Doppler/ultrasound errors in the detection of internal carotid artery occlusion.

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Why the study?

Does carotid Doppler/ultrasound accurately diagnose internal carotid artery occlusion compared to angiography in patients with apparent occlusion?

Population

58 patients with apparent occlusion of an internal carotid artery diagnosed by Doppler/ultrasound who also…

Comparison

Carotid Doppler/ultrasound vs Angiography (reference standard)

Design

Cohort

Authors

SBSamuel L. BridgersDartmouth–Hitchcock Medical Center

Discussion

Member takes

Implication

Caution in relying on Doppler for acute symptomatic carotid occlusion; leaves open need for confirmatory angiography in this high-stakes group.

Key Points

To evaluate the clinical factors associated with Doppler ultrasound errors when distinguishing between total occlusion and near-total occlusion of the internal carotid artery.
Reviewed clinical histories and imaging records for 58 patients with apparent internal carotid artery occlusion diagnosed by Doppler ultrasound who also received catheter angiography.
Stratified patients into two cohorts: those presenting with acute ipsilateral cerebral or ocular events (n=25) and those who were asymptomatic or remotely symptomatic (n=33).
Angiography revealed false-positive occlusion findings in 8 of 58 patients, yielding an overall Doppler ultrasound diagnostic accuracy of 86%.
Diagnostic accuracy was significantly lower among patients with acute ipsilateral neurovascular events (72%; 7 false-positives in 25 patients) compared to asymptomatic or remotely symptomatic patients (97%; 1 false-positive in 33 patients).

Structured PICO

Does carotid Doppler/ultrasound accurately diagnose internal carotid artery occlusion compared to angiography in patients with apparent occlusion?

Population

58 patients with apparent occlusion of an internal carotid artery diagnosed by Doppler/ultrasound who also underwent angiography.

Intervention

Carotid Doppler/ultrasound

Comparator

Angiography (reference standard)

Outcome

Accuracy of Doppler/ultrasound in differentiating occlusion from near-total occlusion (false-positive rate)surrogate

Doppler/ultrasound diagnosis of internal carotid artery occlusion is less accurate in patients with acute ipsilateral symptoms, where detecting continued patency is most critical for management decisions.

Cite This Study

Samuel L. Bridgers (1989) studied this question.

synapsesocial.com/papers/6a7733747d04941475ae32c3 https://doi.org/10.1161/01.str.20.5.612

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Implication

Caution in relying on Doppler for acute symptomatic carotid occlusion; leaves open need for confirmatory angiography in this high-stakes group.

Clinical correlates of Doppler/ultrasound errors in the detection of internal carotid artery occlusion.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Clinical correlates of Doppler/ultrasound errors in the detection of internal carotid artery occlusion.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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