Ultraschall Med 2005; 26 - P085
DOI: 10.1055/s-2005-917585

DUPLEX ULTRASOUND EVALUATION OF PATIENTS WITH CAROTID STENOSIS TREATED WITH STENT IMPLANTATION

M Iacob 1, S Ifrim 1, C Tanasescu 1, R Vasilescu 1
  • 1Internal Medicine Clinic, Echography Department, Colentina Clinical Hospital, Bucharest, Romania

Purpose: Duplex ultrasound is presently the standard non-invasive technique to determine the degree of stenosis and has been widely adopted as a screening method of significant lesions. The aim of our study is to evaluate this technique in patients with significant stenosis of carotid arteries (common or internal) treated with interventional procedures and compare to the angiographis results.

Methods and Materials: Ten patients (pts) with carotid lesions were evaluated before, immediately after stent implantation and at 6-month follow-up (6-mo FU) by duplex ultrasound (DUS) and carotid arteriography (CA). All lesions were located at the bifurcation of the common carotid artery and/or in the proximal 2cm of the internal carotid artery. The degree of stenosis was categorized as mild (with diameter stenosis <40%), moderate (DS: 40–70%) or severe (>70%). The interventional procedures included cerebral protection with filters, stenosis predilatation if necessary and selfexpanding stent implantation.

Results: Ten pts (6 male, mean age 54+/-17 years) with unilateral carotid lesions were evaluated before and immediately after stent implantation. The pre-procedural mean diameter stenosis (DS) was 83+/-12% evaluated by DUS and 78+/-10% by CA; in all cases both DUS and CA indicated severe initial lesions. The post-stent mean residual stenosis measured by DUS was 26+/-16% and 2 lesions were categorized as moderate; CA evaluated all residual lesions as mild (<40%) immediately after stent implantation. At 6-mo FU, 8 pts were evaluated by DUS and CA. DUS indicated a mean DS of 31+/-15% with 3 lesions considered moderate of which 1 lesion was confirmed as moderate by CA. Five lesions were considered mild by both DUS and CA.

Conclusions: In this small group of patients DUS proved to be an important diagnostic follow-up examination for patients treated with stent implantation for carotid stenosis. Compared to CA, the results obtained with DUS tended to overestimate the lesions. A relative good correlation with CA results was obtained in severe or mild carotid lesions but more important discrepancies occurred for moderate stenosis.