Doppler ultrasound performed in a dedicated stroke prevention clinic demonstrated a highly accurate overall misclassification rate of 1.45% compared to conventional cerebral angiography.
Observational (n=67)
Blinded reviewers
No
Does Doppler ultrasound accurately assess internal carotid artery stenosis compared to conventional cerebral angiography in patients at a stroke prevention clinic?
Doppler ultrasound performed in a dedicated stroke prevention clinic is highly accurate for assessing internal carotid artery stenosis, with a misclassification rate of only 1.45% compared to conventional angiography.
Effect estimate: 1.45% (95% CI 0 - 4.3)
INTRODUCTION: Doppler ultrasound (DUS) is used as a screening tool to assess internal carotid artery (ICA) disease. Recent reports suggest that the DUS may be inaccurate in over 28% of patients. We sought to evaluate the accuracy of DUS, when performed in a dedicated stroke prevention clinic (SPC). METHODS: We retrospectively reviewed the charts of patients who had a DUS performed in our SPC, followed by conventional cerebral angiography. Three groups of patients were defined. Group 1 had DUS measured ICA stenosis of >50%; Group II had a DUS measured ICA stenosis of 50%--a misclassification rate of 0%. Group III consisted of five patients in whom DUS showed complete ICA occlusion. The angiogram confirmed the occlusion in all five patients--a misclassification rate of 0%. Overall, misclassification rate was 1.45% (95% CI: 0 - 4.3%). CONCLUSIONS: Doppler ultrasound when performed in a stroke prevention clinic (SPC), has a high accuracy in measuring ICA stenosis of >50%. Doppler ultrasound is reliable in detecting complete ICA occlusion and finally DUS is a reliable screening tool to rule out clinically significant ICA stenosis.
Dean et al. (Mon,) conducted a observational in Transient ischemic attack (TIA) or ischemic stroke (n=67). Doppler ultrasound vs. Conventional cerebral angiography was evaluated on Overall misclassification rate for determining suitability for carotid endarterectomy (1.45%, 95% CI 0 - 4.3). Doppler ultrasound performed in a dedicated stroke prevention clinic demonstrated a highly accurate overall misclassification rate of 1.45% compared to conventional cerebral angiography.