Stroke, Vol 11, 67-71, Copyright © 1980 by American Heart Association
WM Blackshear, DJ Phillips, PM Chikos, JD Harley, BL Thiele and DE Strandness Jr
Duplex scanning provides real time B-mode images of the carotid bifurcation
vessels along with a single gate pulsed Doppler flow velocity detector. By
using the B-mode output of the duplex system to measure the Doppler angle
and spectrum analysis to measure the frequency content of the Doppler
signal, instantaneous flow velocity can be calculated. Mean velocity at
peak systole was calculated retrospectively in 68 common (CCA) and internal
(ICA) carotid arteries of 39 patients who had undergone prior angiography
and prospectively in 30 arteries of 15 healthy young controls. The ratio of
mean peak ICA velocity to mean peak CCA velocity at systole (VICA/VCCA) was
below 0.8 in all 36 normal arteries and above 1.5 in all 21 high-grade
stenoses of 60% or greater diameter reduction. Sixty-one percent of 41
vessels with less than 10 to 55% diameter reduction had a velocity ratio
between 0.8 and 1.5. Only 10% of all ICA's with any stenotic lesion were
incorrectly classified as normal. VICA/VCCA appears to be an accurate
indicator of the degree of ICA stenosis.
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