Journal of Ultrasound in Medicine, Vol 8, Issue 10 535-540, Copyright © 1989 by American Institute of Ultrasound in Medicine
Duplex sonography in patients with hemispheric symptoms
B. A. Carroll
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Many patients with hemispheric neurologic symptoms do not have operative
stenoses of the extracranial carotid arteries. In order to assess the
frequency of such atherosclerotic lesions, 154 patients with documented
hemispheric events underwent duplex Doppler examinations of the
extracranial carotid bifurcation to assess if operative stenosis (70% to
80% stenosis) was present. Seventy-two patients with transient ischemic
attacks (TIA), 62 patients with cerebrovascular accidents (CVA), and 20
patients with amaurosis fugax (AF) were studied. Sixty-nine percent of
patients with TIAs demonstrated a less than 50% stenosis, 52% of patients
with CVAs demonstrated a less than 50% stenosis, and 65% of patients with
AF demonstrated a less than 50% stenosis on duplex Doppler examination.
Intra-arterial digital subtraction angiography (IADSA) was performed in 35
of 154 patients. In all of these 35 cases, ultrasound and angiographic
studies agreed with respect to whether or not a greater than 50% stenosis
was present. Our findings support the use of duplex Doppler sonography as a
triage procedure in patients with hemispheric events in order to determine
those patients who have significant carotid stenoses and who may be
potential operative candidates.
