Comparison of Evaluation of Degree of Carotid Stenosis with Color Doppler Ultrasound and Seldinger Angiography

Objective: Comparison of detection and determination of critical carotid stenosis between two radiological methods: color doppler ultrasound and Seldinger angiography. Methods: This is retrospective study that has included 64 patients that were hospitalized at the Clinic for Vascular surgery, Clinical Centre of University of Sarajevo, from 2006-2008.. 43 patients had carortid artery stenosis from 50-99%, all patients confirmed of having carotid stenosis greater than 60% were subjected to Seldinger angiography. Results confirming critical stenosis of both methods were compared. Degree of carotid stenosis with color doppler was determined on basis of peak systolic velocity and in the case of angiography stenosis was determined by measuring stenotic segment with milimeter tape and comparing it to diameter of normal segment. Results: according to color doppler investigation 32/43 patients had critical carotid stenosis ≥70% . In case of Seldinger angiogram ratio of positive cases was 37/43. In 86% of cases critical stenosis was confirmed by both methods. 5 angiograms showed greater degree of carotid stenosis than color doppler investigation. Out of 2 complete occlussions of internal carotid artery detected by color doppler only one was confirmed by Seldinger angiography, the other was described as stenosis of very high degree.. Discussion: Compatibility of successfull recognition of critical carotid stenosis for both methods is 86%, that figure does not deviate significantly from results pointed out by other studies where compatibility was reported to be 91%. Conclusion: Both methods should be combined in order to make sound indication for operative treatment since beside having segmental stenosis of carotid artery, imperative for carrying out succsseful operation is regular appearance of distal portion of internal carotid artery that is best visualised by one of available angiographies.