Fellow Flownetters, 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 1.3 50 1.6 55 1.9 60 2.2 65 2.5 70 2.8 80 3.4 85 4.0 90+ 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. Bryan Petrisko Boston, MA P.S. - Hello to all my friends in the Green Mountains.