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  • Title: Duplex carotid sonography in distinguishing acute unilateral atherothrombotic from cardioembolic carotid artery occlusion.
    Author: Kimura K, Yonemura K, Terasaki T, Hashimoto Y, Uchino M.
    Journal: AJNR Am J Neuroradiol; 1997 Sep; 18(8):1447-52. PubMed ID: 9296185.
    Abstract:
    PURPOSE: To distinguish between acute complete unilateral cardioembolic and atherothrombotic internal carotid artery (ICA) occlusion by using duplex carotid sonography. METHODS: We studied 11 patients with cardioembolic ICA occlusion (CE group), 32 patients with atherothrombotic ICA occlusion (AT group), and 25 patients with normal angiographic findings (control group). We obtained B-mode scans and measured the end-diastolic flow velocity (EDV) in both common carotid arteries within 3 days of the onset of symptoms. Side-to-side ratios of EDV (ED ratio) were calculated by dividing the flow velocity on the unaffected side by that on the affected side. RESULTS: In the AT group, the proximal ICA was full, with a large area of heterogeneous and partially calcified plaque, and the EDV (10.9 +/- 6.1 cm/s) was significantly lower than that in the control group (20.3 +/- 6.0 cm/s). The ED ratio was greater than 1.4 in all but one patient. In three patients in the CE group, B-mode scans showed a mobile, echogenic intravascular structure in the proximal ICA. The EDV (1.8 +/- 3.4 cm/s) was significantly lower than that in the control and AT groups. The ED ratio was greater than 1.4 in all cases. CONCLUSION: We conclude that B-mode scans and the EDV in the common carotid artery can help to distinguish between acute cardioembolic and atherothrombotic ICA occlusion.
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