Ultraschall in Med 2019; 40(04): 516
DOI: 10.1055/a-0889-8042
Letter to the Editor
© Georg Thieme Verlag KG Stuttgart · New York

Validation of Multiparametric Ultrasonography Criteria with Digital Subtraction Angiography in Carotid Artery Disease: A Prospective Multicenter Study

Gerhard Michael von Reutern
Bad Nauheim, Neurologische Praxis, Bad Nauheim, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
25 June 2019 (online)

Multiparametric Grading of Carotid Stenosis is a Must

What can we learn from this paper by Barlinn et al. [1] and what does it add to our ability to treat patients with carotid artery disease? The authors stated that their aim was to validate the DEGUM consensus for multiparametric grading of carotid stenosis [2]. Years ago when only CW Doppler sonography was available, the positive predictive value for occlusion of the ICA, if diagnosed by well-trained investigators, was about 90 %. This paper reported agreement of only 60 % for the same diagnosis: of 10 occlusions diagnosed with ultrasound, only 6 were confirmed by angiography, despite the use of modern ultrasound technology and the studies being performed by DEGUM-certified examiners. Does this mean that all the technological progress in the last four decades and the increasing understanding of hemodynamics have been in vain?