Consensus criteria would provide standardized parameters for the diagnosis of CS and considerably improve quality of care. Recent proposals rely on a multiparametric approach in which the hemodynamic consequences of carotid narrowing beyond velocity augmentation are considered for an accurate stenosis classification. However, such criteria have received criticism for relying primarily on peak systolic velocities, a parameter that when used in isolation could be misleading. The Society of Radiologists in Ultrasound (SRU), either as originally outlined or in a modified form, are the most common criteria applied. Discrepancies in ultrasound criteria may result in clinically relevant misclassification of disease severity leading to inappropriate referral, or lack of it, to revascularization procedures, and potential for consequential adverse outcome. To date, there is no internationally accepted standard for the gradation of CS. However, as discussed in this review, there is a wide range of practice patterns in use of ultrasound diagnostic criteria for carotid artery stenosis. Duplex ultrasound is the primary noninvasive diagnostic tool for detecting, grading and monitoring of carotid artery stenosis due to its low cost, high resolution, and widespread availability. Catheter-based digital subtraction angiography (DSA) as the diagnostic gold-standard for carotid stenosis (CS) has been replaced by non-invasive techniques including duplex ultrasound, computed-tomography angiography, and magnetic resonance angiography (MRA). Policy of Dealing with Allegations of Research MisconductĪbstract: The risk of new or recurrent stroke is high among patients with extracranial carotid artery stenosis and the benefit of carotid revascularization is associated to the degree of luminal stenosis.Policy of Screening for Plagiarism Process.
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