A new approach for the screening of carotid lesions: a 'fast-track' method with the use of new generation hand-held ultrasound devices.
Aboyans V, Lacroix P, Jeannicot A, Guilloux J, Bertin F, Laskar M.
Department of Thoracic and Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France.
OBJECTIVES: We assessed the usefulness of fast-track neck sonography with a new-generation hand-held ultrasound scanner in the detection of > or =60% carotid stenosis. DESIGN: Patients with a past history of atherosclerotic disease or presence of risk factors were enrolled. All had fast-track carotid screening with a hand-held ultrasound scanner. METHODS: Initial assessment was performed with our quick imaging protocol. A second examiner performed a conventional complete carotid duplex as gold-standard. RESULTS: We enrolled 197 consecutive patients with a mean age of 67 years (range 35-94). A carotid stenosis >60% was detected in 13 cases (6%). The sensitivity, specificity, positive and negative predictive value of fast-track sonography was 100%, 64%, 17% and 100%, respectively. Concomitant power Doppler imaging during the fast-track method did not improve accuracy. CONCLUSIONS: The use of a fast-track method with a hand-held ultrasound device can reduce the number of unnecessary carotid Duplex and enhance the screening efficiency without missing significant carotid stenoses.
PMID: 15288637 [PubMed - indexed for MEDLINE]