Abstract
Digital subtraction angiography (DSA) is considered the reference method for the assessment of carotid artery stenosis; however, the procedure is invasive and accompanied by ionizing radiation. Velocity estimation with duplex ultrasound (DUS) is widely used for carotid artery stenosis assessment since no radiation or intravenous contrast is required; however, the method is angle-dependent. Vector concentration (VC) is a parameter for flow complexity assessment derived from the angle independent ultrasound method vector flow imaging (VFI), and VC has shown to correlate strongly with stenosis degree. The aim of this study was to compare VC estimates and DUS estimated peak-systolic (PSV) and end-diastolic velocities (EDV) for carotid artery stenosis patients, with the stenosis degree obtained with DSA. Eleven patients with symptomatic carotid artery stenosis were examined with DUS, VFI, and DSA before and after stent treatment. Compared to DSA, VC showed a strong correlation (r = −0.79, p < 0.001), while PSV (r = 0.68, p = 0.002) and EDV (r = 0.51, p = 0.048) obtained with DUS showed a moderate correlation. VFI using VC calculations may be a useful ultrasound method for carotid artery stenosis and stent patency assessment.
Highlights
The presence of carotid artery stenosis is clinically relevant, as 10–15% of all ischemic strokes are caused by carotid lumen reduction [1]
Patients examined with Digital subtraction angiography (DSA), Duplex ultrasound (DUS), and vector flow imaging (VFI) before and after Carotid artery stenting (CAS) treatment were included in the study analysis
Mean values and mean differences between Vector concentration (VC), peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean stenosis degree are given in treatment (Table 2)
Summary
The presence of carotid artery stenosis is clinically relevant, as 10–15% of all ischemic strokes are caused by carotid lumen reduction [1]. A precise diagnosis of carotid artery stenosis is crucial in the decision of the optimal treatment for each patient [2]. Digital subtraction angiography (DSA) is considered the reference method for carotid artery stenosis assessment; the procedure is invasive and accompanied by ionizing radiation for the patient [4,5]. Duplex ultrasound (DUS) using spectral Doppler ultrasound is widely used for carotid artery stenosis assessment and for treatment decision-making, as it is non-ionizing and does not require the administration of an intravenous contrast agent. DUS is less expensive and Diagnostics 2020, 10, 420; doi:10.3390/diagnostics10060420 www.mdpi.com/journal/diagnostics
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