Paul, you could possibly have a negative number as well, not just a over
estimation. The diameter reduction from the proximal ICA also becomes
trivial, as you said with severe calcification. Then again the majority of
critical findings are severly calcific. The measurements used in the angio
suites are a bit easier and are based on assumptions that the distal ICA is
about the same size as the proximal. Not to mention you have a radiographic
image that is filled with dye. Diameter reduction works for the most part if
you can make out the true proximal lumen without all the limitations.
>From: Paul J Graham <[log in to unmask]>
>Reply-To: UVM Flownet <[log in to unmask]>
>To: [log in to unmask]
>Subject: Diameter reduction protocols
>Date: Fri, 1 Jun 2007 23:17:31 -0400
>Does anyone use the North american Method for diameter reductions in
>arteries at their Lab, this is also known as the "distal" stenosis method.
>This method is acheived by measuring the diameter of the site in the
>that is most stenosed, and then going distally in the Carotid to an
>unaffected site and taking another measurment and comparing the two for the
>diameter reduction measurment.
>All of the Labs that I have worked in or have been exposed to at this point
>and time have used the European meathod in which you measure the most
>stenotic site and then the diameter of the original lumen at the exact same
>point in the carotid.
>Also what would be the advantage to actually using the North american
>"distal" method? With most newer ultrasound machines I have found it
>relatively easy in the majority of cases, Excluding highly calcific
>plaque's, to identify the normal lumen and measure the original diameter at
>the site of stenosis. I would think that because the carotids diameter
>decreases distally this would give you falsly elevated diameter reductions
>Thoughts and responses
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