Accuracy and indications of diagnostic studies for extracranial carotid disease
J. E. Connolly, D. A. Brownell, E. F. Levine and P. M. McCart
We reviewed extracranial carotid studies in two groups of patients. The
first group consisted of 200 patients who had been evaluated by both duplex
scanning (DS) and direct arch-selective carotid arteriography (SCA). The
second group consisted of 100 patients who had been evaluated by both
intravenous digital subtraction angiography (IDSA) and conventional SCA. In
200 patients DS disclosed a 92% accuracy in delineating stenotic internal
carotid disease and was accurate in recognizing ulcerative disease in 76%
of patients. A review of the 100 patients studied by both IDSA and SCA
showed that in 40% IDSA gave excellent correlation with SCA; in 35%, good
correlation; and in 25%, poor correlation. In 10% DS was more accurate in
delineating ulcerative disease than was IDSA, and on occasion DS was even
more diagnostic than SCA. The relative accuracy, cost, risk, and clinical
usefulness of each carotid diagnostic modality are discussed.
