Abstract
As noted previously, the carotid consensus criteria recommended that a peak systolic velocity (PSV) of internal carotid artery (ICA) >230 cm/s to be utilized in detecting ≥70–99% carotid stenosis. Few studies appraised the consensus criteria and analyzed this PSV in detecting >70% with a reasonable accuracy. A PSV of 240 cm/s in our institution carried a similar overall accuracy of 94% with a slightly better positive predictive value (PPV) of 94%. Some authorities suggested that the higher the ICA PSV of >230 cm/s were more likely to detect >70% stenosis. This chapter will show that a higher PSV >230 cm/s may somewhat increase the PPV by a few percent, but at the expense of extremely low sensitivity and negative predictive value. Therefore, while this principle might be somewhat accurate in increasing the PPV, its use might be detrimental in lowering the sensitivity of this value and therefore, it is not recommended.
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References
Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis – society of radiologists in ultrasound consensus conference. Radiology. 2003;229:340–6.
AbuRahma AF, Srivastava M, Stone PA, Mousa AY, Jain A, Dean LS, Keiffer T, Emmett M. Critical appraisal of the carotid duplex consensus criteria in the diagnosis of carotid artery stenosis. J Vasc Surg. 2011;53:53–60.
Armstrong PA, Bandyk DF, Johnson BL, Shames ML, Zwiebel BR, Back MR. Duplex scan surveillance after carotid angioplasty and stenting: a rational definition of stent stenosis. J Vasc Surg. 2007;46:460–6.
Intersocietal Accreditation Commission. IAC vascular testing white paper on carotid stenosis interpretation criteria. Carotid Stenosis Diagnosis Criteria; 2014. p. 1–2.
Braun RM, Bertino RE, Milbrandt J, Bray M. Ultrasound imaging of carotid artery stenosis: application of the Society of Radiologists in ultrasound consensus criteria to a single institution clinical practice. Ultrasound Q. 2008;24:161–6.
Shaalan WE, Wahlgren CM, Desai T, Piano G, Skelly C, Bassiouny HS. Reappraisal of velocity criteria for carotid bulb/internal carotid artery stenosis utilizing high-resolution B-mode ultrasound validated with computed tomography angiography. J Vasc Surg. 2008;48:104–13.
North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–53.
Moneta GL, Edwards JM, Chitwood RW, Taylor LM, Lee RW, Cummings CA, et al. Correlation of North American Symptomatic Carotid Endarterectomy Trial (NASCET) angiographic definition of 70% to 99% internal carotid artery stenosis with duplex scanning. J Vasc Surg. 1993;17:152–9.
Forjoe T, Rahi MA. Systematic review of preoperative carotid duplex ultrasound compared with computed tomography carotid angiography for carotid endarterectomy. Ann R Coll Surg Engl. 2019;101(3):141–9.
Jahromi AS, Cina CS, Liu Y, Clase CM. Sensitivity and specificity of color duplex ultrasound measurement in the estimation of internal carotid artery stenosis: a systematic review and meta-analysis. J Vasc Surg. 2005;41:962–72.
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AbuRahma, A.F., Adams, E.M. (2022). Correlation of Doppler PSV >230 c/s to Positive Predictive Value in Predicting >70% and >80% Carotid Stenosis. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-60626-8_64
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DOI: https://doi.org/10.1007/978-3-030-60626-8_64
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