September 1999


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Deborah Richert <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Sun, 5 Sep 1999 18:04:40 -0500
text/plain (38 lines)
>Date: Sun, 05 Sep 1999 17:59:14 -0500
>To: UVM Flownet <[log in to unmask]>
>From: Deborah Richert <[log in to unmask]>
>Subject: Re: Carotid stenosis.
>At 11:16 PM 9/3/99 +-200, you wrote:
>>        Hello Flownetters,
>>I would like to request some advice on the evaluation of carotid stenosis.
>>In our Hospital we measure stenosis by ultrasound comparing the diameter
of the lumen with the diameter of the vessel at the point of maximum
stenosis (real stenosis), but correlation  with the results of arteriography
is sometimes poor because they compare the diameter of the lumen with the
distal diameter of the carotid.
>>Do you think that we must do the same by ultrasound?
>>Carlos Nicolau
>Yes, Carlos.  You should measure the percent stenosis by ultrasound the
same way that your angiography department measures percent stenosis.  By
measuring the distal vessel diameter you are measuring the vessel at the
more normal diameter.  For example, if you measure the tightest area of
stenosis in the proximal ICA, and this is where the carotid bulb is, you
will get a falsely high percent stenosis if you also measure the diameter of
the vessel here, because this is where the vessel is the widest.  Measure
the diameter of the vessel more distally, and you will get a more accurate
percent stenosis by color angio.
>Deb Richert, RDMS, RVT
>La Crosse, WI
I forgot to add that velocity criteria is the most important, and that
measuring percent stenosis by ultrasound color angio may be helpful in
determining mild vs. moderate stenosis, for example.