Advanced Search

Home > Journals > International Angiology > Past Issues > International Angiology 1998 December;17(4) > International Angiology 1998 December;17(4):248-54



A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899

Frequency: Bi-Monthly

ISSN 0392-9590

Online ISSN 1827-1839


International Angiology 1998 December;17(4):248-54


Carotid ­duplex ultra­so­nog­ra­phy: impor­tance of stan­dar­disa­tion

Bryd Sh., Robless P., Baxter A., Emson M., Halliday A. on ­behalf of the Asymptomatic Carotid Surgery Trial Col­lab­o­ra­tors and Vas­cu­lar Labor­a­to­ries

ACST, Academic Surgical Unit, ICSM St. Mary’s Hospital, London, UK

Background. Carotid ­duplex ultra­so­nog­ra­phy (CDUS) is an estab­lished non-inva­sive tool for assess­ing ­patients with sus­pect­ed carot­id bifur­ca­tion dis­ease. Current ­trends show an ­increased depen­dence on CDUS in rec­om­mend­ing ­patients for ­stroke pre­ven­tion sur­gery. The aim of the study was to eval­u­ate rou­tine prac­tice in vas­cu­lar labor­a­to­ries ­across 26 coun­tries par­tic­i­pat­ing in The Asymptomatic Carotid Surgery Trial (ACST), and to deter­mine the areas which are in need of ­future stan­dar­disa­tion if CDUS is to be the pri­mary tool in rec­om­mend­ing ­patients for CEA.
Methods. Retrospective. Information was gath­ered from ques­tion­naires, and 22 on-site vis­its of vas­cu­lar labor­a­to­ries ­between August 1996 to September 1997. Setting. Clinical vas­cu­lar labor­a­to­ry prac­tice. Participants. Eligible par­tic­i­pants were vas­cu­lar labor­a­to­ries of ACST col­lab­o­ra­tors. Measures. Laboratories were com­pared in 7 cat­e­go­ries: ultrasound equipment, operators, experience, protocols, stenosis evaluation, interpretation criteria, and reporting.
Results. Information on 117 respon­dents ­showed that (i) experience: at least one oper­a­tor in each labor­a­to­ry had more than 3 years expe­ri­ence; (ii) equipment: 88% (103/117) had ­colour ­duplex capa­bil­ity; (iii) operators: 54% of labor­a­to­ries had exams per­formed by tech­nol­o­gists, 33% vas­cu­lar sur­geons, 28% radiol­o­gists, and 35% other. The most sig­nif­i­cant find­ings were in (iv) stenosis eval­u­a­tion: only 29% (33/117) were using a stan­dar­dised Doppler angle (this sin­gle fac­tor may great­ly alter exam ­results); and (v) interpretation criteria; with >41 dif­fer­ent cri­te­ria report­ed. These spe­cif­ic labor­a­to­ry vari­a­tions can ­affect those ­patients con­sid­ered appro­pri­ate for CEA.
Conclusions. This study high­lights the most sig­nif­i­cant areas for ­future stan­dar­disa­tion to be Doppler angle and interpretation criteria, if CDUS is to be a pri­mary tool in rec­om­mend­ing ­patients for CEA, when indi­cat­ed by clin­i­cal trial ­results.

language: English


top of page