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  • Title: Carotid duplex scanning: patterns of referral and outcome.
    Author: Perkins JM, Collin J, Walton J, Hands LJ, Morris PJ.
    Journal: Eur J Vasc Endovasc Surg; 1995 Nov; 10(4):486-8. PubMed ID: 7489219.
    Abstract:
    OBJECTIVE: Review of the results of carotid Duplex scanning. DESIGN: Retrospective review of new referrals for carotid Duplex scanning to a regional vascular laboratory. MATERIALS: 1041 referrals made over an 18 month period. METHODS: Referrals were reviewed for scan quality, diagnostic category and outcome of scanning. RESULTS: The overall detection rate of ipsilateral stenoses > 70% and occlusions was 13.5%; the detection rate of surgically significant carotid lesions (70-99%) was only 8%. Analysis by diagnostic category revealed a significantly greater detection rate for carotid lesions > 70% in patients presenting with amaurosis fugax (24%) in comparison to those with TIAs (9.5%, p = 0.0005) or following a stroke (13%, p = 0.01). Patients referred with asymptomatic bruits or prior to cardiac surgery showed a positive scan rate of 30%. Sixty-seven carotid endarterectomies have resulted from scans performed in this period. CONCLUSION: The overall rate of detection for surgically relevant lesions is low, but in comparison to a similar audit conducted in 1992, the absolute number of carotid lesions > 70% has risen by 60%. An 8% detection rate for surgically relevant lesions may be valuable in projecting the need for carotid endarterectomy arising from a given number of Duplex scans.
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