Exploring the optimization of duplex velocity criteria for the diagnosis of ICA stenosis


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Online first at Vascular Medicine, researchers in the vascular testing division of the Intersocial Accreditation Commission (IAC) report the results of their multicenter duplex ultrasound study for the diagnosis of internal carotid artery stenosis (ICA).

The study was developed in response to a wide variability in the was used to classify the severity of ICA stenosis in vascular laboratories across the country and following a survey of IAC-accredited facility members who supported efforts toward standardization. The main objective of the study was to evaluate the widely used SRU consensus criteria (SRUCC) and, if necessary, to propose further optimization of these criteria.

The researchers found that carotid duplex interpretation using SRUCC produced a significant overestimation of stenosis for both moderate (50–69%) and severe (> 70%) ACI lesions as determined by catheter angiography. The authors conclude that laboratories currently using SRUCC should consider modifying existing criteria to incorporate more stringent and accurate parameters for ICA stenosis greater than 50% by increasing the maximum systolic velocity threshold (PSV) to> 180 cm / sec or requiring the ACI / CCA PSV ratio> 2.0 in addition to PSV> 125 cm / sec.

“This study reflects more than six years of work by a team of IAC staff and multi-specialty volunteers with case study materials collected at 11 centers across the country. Although SRUCCs are widely used, had never been formally compared to the gold standard of we have shown that the use of SRUCC overestimated the degree of ICA stenosis and [we] identify potential opportunities for modifications that could ultimately allow for greater accuracy and consistency in the interpretation of ICA in all vascular laboratories, ”said lead researcher Heather L. Gornik, MD, IAC Vascular Testing Immediate Past -President.

“Through the use of real-world data from IAC-accredited vascular laboratories, this paper highlights the opportunity to improve the quality of care for patients with carotid disease,” said Tatjana Rundek, MD, Ph.D. .D., President of IAC vascular testing. “By modifying existing criteria to incorporate more accurate parameters and the overall implementation of these criteria, the accuracy of ultrasound diagnostic tests can be improved throughout our vascular community.”

As a next step, IAC vascular testing will disseminate a white paper document that summarizes the results of the study and provides guidance to vascular laboratories for the implementation of criteria and other steps toward standardization throughout the community. of vascular testing. The full study report can be accessed through open access Vascular Medicine. Affiliations and disclosures of conflicts of interest of the authors and the list of participating study centers are available in the article.

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More information:
Heather L Gornik et al, Optimization of Duplex Speed ​​Criteria for the Diagnosis of Internal Carotid Artery Stenosis (ICA): Report of the Carotid Diagnostic Criteria Commission of the Vascular Testing Division of the Commission Intersocial Accreditation (IAC), Vascular Medicine (2021). DOI: 10.1177 / 1358863X211011253

Provided by the Intersocietal Accreditation Commission

Citation: Exploring Duplex Speed ​​Criteria Optimization for ICA Stenosis Diagnosis (2021, May 27) Retrieved May 28, 2021 at https://medicalxpress.com/news/2021-05-exploring-optimization -duplex-velocity-criteria.html

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