Why the study?
Do auscultation, CW Doppler imaging, and IV DSA accurately detect carotid artery disease compared to conventional angiography in patients evaluated for carotid disease?
Do auscultation, CW Doppler imaging, and IV DSA accurately detect carotid artery disease compared to conventional angiography in patients evaluated for carotid disease?
The combination of continuous wave Doppler imaging and intravenous digital subtraction angiography provides a highly sensitive and specific alternative to conventional angiography for detecting significant carotid artery stenosis and occlusion.
May support combined noninvasive carotid testing; leaves open prospective validation before practice change.
The reliability of auscultation, continuous wave (CW) Doppler imaging, and intravenous digital subtraction angiography (IV DSA) in the assessment of carotid artery disease has been evaluated in comparison with conventional angiography in 30 patients. With auscultation, specificity and sensitivity for internal carotid artery (ICA) stenosis of 50% or more were 81% and 67% respectively. CW Doppler imaging detected ICA stenosis of 50% or more with a sensitivity of 83% and a specificity of 92% and ICA occlusion with a sensitivity of 60%. The specificity of IV DSA was 95% and the sensitivity for ICA stenosis of 50% or more and ICA occlusion were 75% and 100% respectively. Combining CW Doppler and IV DSA findings raised sensitivity for ICA stenosis of 50% or more and ICA occlusion to 89% and 100% respectively and specificity to 95%. The combination of CW Doppler and IV DSA is a safe and accurate test battery in the detection and categorization of carotid disease.
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Caes et al. (1987) studied this question.
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