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Brouwers JJWM, Jiang JFY, Feld RT, et al. A New Doppler-Derived Parameter to Quantify Internal Carotid Artery Stenosis: Maximal Systolic Acceleration. Ann Vasc Surg. 2021;doi: 10.1016/j.avsg.2021.09.056.
Brouwers, J. J. W. M., Jiang, J. F. Y., Feld, R. T., van Doorn, L. P., van Wissen, R. C., van Walderveen, M. A. A., Hamming, J. F., & Schepers, A. (2021). A New Doppler-Derived Parameter to Quantify Internal Carotid Artery Stenosis: Maximal Systolic Acceleration. Annals of vascular surgery, . https://doi.org/10.1016/j.avsg.2021.09.056
Brouwers, Jeroen J W M, et al. "A New Doppler-Derived Parameter to Quantify Internal Carotid Artery Stenosis: Maximal Systolic Acceleration." Annals of vascular surgery vol. (2021). doi: https://doi.org/10.1016/j.avsg.2021.09.056
Brouwers JJWM, Jiang JFY, Feld RT, van Doorn LP, van Wissen RC, van Walderveen MAA, Hamming JF, Schepers A. A New Doppler-Derived Parameter to Quantify Internal Carotid Artery Stenosis: Maximal Systolic Acceleration. Ann Vasc Surg. 2021 Nov 12; doi: 10.1016/j.avsg.2021.09.056. Epub 2021 Nov 12. PMID: 34780944.
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Ann Vasc Surg. 2021 Nov 12; doi: 10.1016/j.avsg.2021.09.056. Epub 2021 Nov 12.

A New Doppler-Derived Parameter to Quantify Internal Carotid Artery Stenosis: Maximal Systolic Acceleration.

Annals of vascular surgery

Jeroen J W M Brouwers, Janey F Y Jiang, Robert T Feld, Louk P van Doorn, Rob C van Wissen, Marianne A A van Walderveen, Jaap F Hamming, Abbey Schepers

Affiliations

  1. Department of Vascular Surgery, Leiden University Medical Center, The Netherlands; Department of Surgery, HagaHospital, The Hague, The Netherlands. Electronic address: [email protected].
  2. Department of Radiology, Leiden University Medical Center, The Netherlands.
  3. Department of Vascular Surgery, Leiden University Medical Center, The Netherlands.

PMID: 34780944 DOI: 10.1016/j.avsg.2021.09.056

Abstract

OBJECTIVE: Doppler ultrasonography (DUS) is used as initial measurement to diagnose and classify carotid artery stenosis. Local distorting factors such as vascular calcification can influence the ability to obtain DUS measurements. The DUS derived maximal systolic acceleration (ACCmax) provides a different way to determine the degree of stenosis. While conventional DUS parameters are measured at the stenosis itself, ACCmax is measured distal to the internal carotid artery (ICA) stenosis. The value of ACCmax in ICA stenosis was investigated in this study.

MATERIAL AND METHODS: All carotid artery DUS studies of a tertiary academic center were reviewed from October 2007 until December 2017. Every ICA was included once. The ACCmax was compared to conventional DUS parameters: ICA peak systolic velocity (PSV), and PSV ratio (ICA PSV/ CCA PSV). ROC-curve analysis was used to evaluate accuracy of ACCmax, ICA PSV and PSV ratio as compared to CT-angiography (CTA) derived stenosis measurement as reference test.

RESULTS: The study population consisted of 947 carotid arteries and was divided into 3 groups: <50% (710/947), 50-69% (109/947), and ≥70% (128/947). Between these groups ACCmax was significantly different. Strong correlations between ACCmax and ICA PSV (R

CONCLUSIONS: ACCmax is an interesting additional DUS measurement in determining the degree of ICA stenosis. ACCmax is measured distal to the stenosis and is not hampered by local distorting factors at the site of the stenosis. ACCmax can accurately diagnose an ICA stenosis, but was somewhat inferior compared to ICA PSV and PSV ratio to diagnose a ≥50% ICA stenosis.

Copyright © 2021. Published by Elsevier Inc.

Keywords: Atherosclerosis; Carotid artery stenosis; Carotid endarterectomy; Computed tomography angiography; Diagnostic imaging; Doppler ultrasonography

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