The ICA/CCA systolic ratios negate the effects of localized changes in the carotid vessels due to collateralization  and/or severe contra lateral disease.
The ICA/CCA systolic ratio has been used in our lab for over 10 years with good correlation results.

Diana Call, B.S., R.V.T.
Vascular Surgery Division/Lab Manager
Johns Hopkins University
(410) 614-8522

>>> "Schneider, Joseph R." <[log in to unmask]> 4/29/2009 10:24 AM >>>
There is a literature discussing this, but we have never been convinced that there is a clear adjustment for the threshold when the contralateral ICA is occluded (sensitivity and specificity not great for any proposed threshold that we have seen) so I try to incorporate a comment in my reading that just says something like  "This may be an overestimate of stenosis due to compensatory flow related to contralateral internal carotid artery occlusion."

Joseph R. Schneider, M.D., Ph.D., F.A.C.S.
Vascular and Interventional Program of Central DuPage Hospital
Ambulatory Services Pavilion Suite 201
25 North Winfield Road
Winfield, IL 60190
Voice: 630-933-4487
Fax: 630-933-2009
Professor of Surgery, Northwestern University Medical School
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>ICAVL requesting the criteria for carotid doppler study where one ICA is
occluded and contralateral ICA stenosis could be overestimated because of
compensatory effect. How much overestemated. I need criteria.
>Please help.
>Thank you 
>Marina Dvorkin
>vascular tech

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