What question did this study set out to answer?

To evaluate the reliability, applicability, and pathologic accuracy of the Carotid Stenosis Index compared with established NASCET and ECST angiographic measurement techniques.

February 1, 1995Stroke

Carotid Stenosis Index

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Why the study?

Does the Carotid Stenosis Index (CSI) improve the reliability and applicability of measuring carotid stenosis compared to NASCET and ECST methods?

Population

57 patients previously screened with duplex ultrasonography, including a subset of 30 patients undergoing…

Comparison

Carotid Stenosis Index method for measuring… vs NASCET and ECST methods

Design

Cross-sectional, Three blinded observers evaluated the angiograms

Authors

CBChristopher F. BladinFlorey Institute of Neuroscience and Mental Health AAAndrei V. AlexandrovNorthwestern University JMJennifer MurphyChildren's Hospital of Philadelphia

Discussion

Member takes

Implication

CSI offers near-universal applicability with consistent measurements; leaves open outcome impact versus NASCET/ECST pending prospective validation.

Key Points

To evaluate the reliability, applicability, and pathologic accuracy of the Carotid Stenosis Index compared with established NASCET and ECST angiographic measurement techniques.
Three blinded observers evaluated angiograms from 57 patients (114 carotid arteries) previously screened with duplex ultrasonography using NASCET, ECST, and the new Carotid Stenosis Index (CSI) methods.
CSI derived normal internal carotid artery (ICA) diameter mathematically using the anatomical relationship of 1.2 times the common carotid artery (CCA) diameter.
A subset of 30 patients who underwent carotid endarterectomy had their angiographic measurements compared against computerized carotid plaque planimetry.
CSI was applicable in 99% of cases, compared with 89% for NASCET (which had an additional 9% negative stenosis cases) and 95% for ECST.
Interobserver comparison by ANOVA showed significant variation for NASCET (P < .0001, sevenfold variation) and ECST (P < .001, twofold variation), but no significant variation for CSI (P = NS).
Individual measurement 95% confidence intervals were ±15% for CSI, ±19% for ECST, and ±30% for NASCET, and area derivations for NASCET differed significantly from plaque planimetry (P < .0001) while CSI did not.

Structured PICO

Does the Carotid Stenosis Index (CSI) improve the reliability and applicability of measuring carotid stenosis compared to NASCET and ECST methods?

Population

57 patients (114 carotid arteries) previously screened with duplex ultrasonography, including a subset of 30 patients undergoing carotid endarterectomy.

Intervention

Carotid Stenosis Index (CSI) method for measuring carotid stenosis on angiograms

Comparator

NASCET and ECST methods

Outcome

Applicability, interobserver and intraobserver reliability, and comparison to computerized carotid plaque planimetrysurrogate

The Carotid Stenosis Index (CSI) is a highly applicable and reliable method for measuring carotid stenosis that correlates well with duplex ultrasound and carotid pathology.

Cite This Study

Bladin et al. (1995) studied this question.

synapsesocial.com/papers/6a7ea5efe7861671be8ec6df https://doi.org/10.1161/01.str.26.2.230

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Implication

CSI offers near-universal applicability with consistent measurements; leaves open outcome impact versus NASCET/ECST pending prospective validation.

Carotid Stenosis Index

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Carotid Stenosis Index

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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