Measuring the degree of ICA stenosis: how to do it? Consensus and case reports

The main parameter that should be used in diagnosing and grading the internal carotid artery (ICA) hemodynamic stenosis is the peak systolic velocity (PSV), but grading based only on the PSV is not sufficient to differentiate a moderate from a severe (70% NASCET) stenosis with sufficient clinical reliability. In these cases the PSV criterion taken alone is of limited value.

Grading based on a set of main and additional criteria can overcome diagnostic errors: in particular it is recommended the study of the post stenotic flow velocity distal to flow disturbances and the study of the collateral flows through the anterior/posterior communicating artery.

In this lesson are reported: A) the recommendations proposed by two Consensus Panels (1. Society of Radiologists in Ultrasound Consensus Conference. Radiology 2003; and 2. Neurosonology Research Group of the World Federation of Neurology. Stroke 2012) in order to provide reliable information regarding the diagnosis of the degree of ICA stenosis; B) some explicative case reports.



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