I have recently begun working at a new vascular laboratory in which the
carotid stenosis criteria differs from the U. of Washington guidelines that I
have used in the past. Briefly, here is the criteria used in this lab:
VELOCITY (m/sec) % STENOSIS
I am yet to learn exactly where this criteria was developed, and what study
it is based on. If anyone has seen this before, please tell me.
The real problem I have with this criteria is that certain radiologists
here use this not just to grade ICA stenosis, but ECA stenosis as well. I am
unaware of any studies to back up ECA criteria. In the past, I have "soft
called" ECA stenosis, as either less than or greater than 50%. I look at
things such as turbulence, spectral broadening, the presence of plaque on
B-mode, and whether there is a FOCAL area of increased velocities within the
vessel to make my decision. I was told today by a reading radiologist here
that I should be using the same criteria for both ICA and ECA stenoses. I
have a real problem with this, and would like to dispute her on this point,
yet before doing so I would like available feed back from the great minds on
the Flownet. Does anyone out there use this criteria for ICA and/or ECA
stenoses? Is anyone aware of any published studies on ECA criteria? Any
advice would be greatly appreciated.
P.S. - Hello to all my friends in the Green Mountains.