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Dennis F. Bandyk, MD; Arnold W. Levine, MD; Linda Pohl, RN; Jonathan B. Towne, MD

Arch Surg. 1985;120(3):306-314.

Abstract
• Spectrum analysis of continuous-wave Doppler recordings from the region of the carotid bifurcation was used to classify the degree of stenosis in the internal (ICA) and external (ECA) carotid arteries. Measurements of systolic peak frequency, end-diastolic frequency, and the degree of spectral broadening were used to define five ICA disease categories: 0% to 15% diameter reduction (DR), 16% to 49% DR, 50% to 80% DR, greater than 80% DR, and occlusion. The results were compared to contrast arteriography in 122 patients (243 arteries). The agreement with angiography in classifying ICA stenosis was 82%. Doppler spectrum analysis identified 96% of hemodynamically significant disease (>50% DR) in the ICA and ECA and 97% of ICA occlusions. Attention to the common carotid artery waveform and the ICA diastolic frequency improved the accuracy of predicing greater than 80% DR and occlusion of the ICA. Noninvasive classification of carotid bifurcation disease is useful in clinical decision making to select the angiographic technique most likely to accurately define disease morphology and to follow up patients for disease progression.

(Arch Surg 1985;120:306-314)

Author Affiliations
From the Surgical Service, Veterans Administration Medical Center-Wood, Milwaukee (Drs Bandyk and Towne and Ms Pohl); and the Department of Surgery, The Medical College of Wisconsin, Milwaukee (Drs Bandyk, Levine, and Towne).

Footnotes
Accepted for publication Aug 29, 1984.

Read before the Eighth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Los Angeles, May 10, 1984.

Reprint requests to Department of Surgery, Milwaukee County Medical Complex, 8700 W Wisconsin Ave, Milwaukee, WI 53226 (Dr Bandyk).

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