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Duplex Criteria for Carotid Artery Stenosis
Korean J Vasc Endovasc Surg 2011;27:108-113
Published online August 31, 2011;  https://doi.org/10.5758/kjves.2011.27.3.108
© 2011 The Korean Society for Vascular Surgery.

Jin Hyun Joh, M.D.1, Hyung Joon Ahn, M.D.1, Deok Ho Nam, M.D.2 and Ho Chul Park, M.D.1
Abstract
Purpose: Various duplex criteria have been used to predict hemodynamically significant carotid artery stenosis. Clinicians have relied on published institutional experience for carotid duplex ultrasound interpretation. Duplex parameters for interpreting carotid artery stenosis severity consist of peak systolic velocity (PSV) and end-diastolic velocity of the internal carotid artery (ICA), the ratio of ICA PSV and end-diastolic velocity (EDV) to common carotid artery (CCA) PSV (PSVICA/CCA) and EDV (EDVICA/CCA). This study was performed to elucidate which duplex parameter can predict the severity of the carotid artery stenosis more accurately.
Methods: The carotid duplex ultrasound and angiographic results of 121 carotid arteries were analyzed. Receiver operater characteristic (ROC) curves were used to compare PSV, EDV, and both ratios in detecting ≥50%, ≥60%, and ≥70% stenosis of the internal carotid artery.
Results: The PSVICA/CCA ratio can accurately detect ≥50%, ≥60%, and ≥70% stenosis of the internal carotid artery. To detect ≥50% angiographic stenosis, a PSVICA/CCA ratio of 1.2 has a sensitivity of 83% and specificity of 77%. A PSVICA/CCA ratio of 1.8 can detect ≥60% angiographic stenosis with a sensitivity of 80% and specificity of 79%. Finally, a PSVICA/CCA ratio of 2.2 can detect ≥70% angiographic stenosis with a sensitivity and specificity of 70 and 89%, respectively.
Conclusion: The PSVICA/CCA ratio can be used for detecting internal carotid artery angiographic stenosis. PSVICA/CCA ratios of 1.2, 1.8, and 2.2 are proper criteria for interpreting 50%≤, 60%≤ and 70%≤ stenosis, respectively.
Keywords: Carotid stenosis, Duplex, Criteria
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