Noninvasive Preoperative Evaluation of Carotid Atheroma: Echo-Color-Doppler Versus Duplex Scanning

Seventy-two internal carotid arteries in 36 patients (33 men and 3 women) were examined by echo-color-Doppler with and without the insertion of the color function. Subsequently, within one month of the ultrasound evaluation, the 36 patients underwent digitalized angiography of the epiaortic truncus by arterial catheterization. Eight endarterectomies (EAs) of the internal carotid artery were performed on 7 patients (1 patient had surgery on both sides) who presented stenosis greater then 70 % during angiography, and 2 patches of external carotid artery were performed. The authors have found no significant different (t test) between the perfect agreement of the echo-color-Doppler (87.5%) and the perfect agreement of the duplex scanning (79.1 %) (P=0.079). The difference between the two methods in underreading (P=0.144) or over-reading (P=0.160) the stenosis was insignificant. If only the third class of stenosis is considered (50-80%), the class where all the internal carotid arteries that underwent EA surgery are concentrated, the perfect agreement is significantly greater for echo-color-Doppler (79.4%) than for duplex scanning (67,65%) (P = 0.021). The authors believe that echo-color-Doppler facilitates the diagnosis of the lesion by means of the immediate identification of even minimal turbulence even though it offers the same possibility as duplex scanning for morphologic and structural study of the atherosclerotic plaque