Ultrasound Assessment of Internal Carotid Stenosis Pre- and Post-endarterectomy of Contralateral Near-occluded Carotid

Internal carotid artery (ICA) stenosis often presents bilaterally and is a major cause of stroke. Carotid duplex ultrasound used for estimation via peak systolic velocity (PSV), end diastolic (EDV), ICA/common (CCA) ratio. endarterectomy (CEA) common surgery ICA carries high risk stroke mortality. In near occlusion with >90% stenosis, collateral flow through contralateral can compensate increased velocities, artificially elevating stenosis. We hypothesize that by estimating velocities the unoperated pre- post CEA near-occluded ICA, we better estimate artificial elevation ipsilateral A retrospective study was conducted on 239 patients, >18 years old, who underwent routine examination 2 at single institution. Qualified patients had bilateral occlusive disease one side CEA. Near determined showing or CTA interpreted physician. Preoperative to were recorded compared postoperatively 6 months. Student t test in these analyses. Post-CEA occluded PSV, EDV, ICA/CCA ratio significantly decreased (PSV pre-CEA = 145 ± 80 vs post-CEA 128 67; P < .001; EDV 42 28 36 230; 1.85 1.2 1.75 1.2; .032). Based new values if classify as <50%, there an 81.6% increase cases post-CEA. If 50% 69%, 72.2%. >70%, 26.7%. Finally, classifying 80% 99%, 100%. The are elevated presence innate occlusion, (Figure). This provides novel insight into revision criteria accurate avoid unnecessary high-risk surgery.