Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis |
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Authors: | Ivan N Staikov Marcel Arnold Heinrich Mattle Luca Remonda Matthias Sturzenegger RalfW Baumgartner Gerhard Schroth |
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Institution: | (1) Department of Neurology, Inselspital, 3010 Bern, Switzerland, Tel.: +49-31-6322111, Fax: +49-31-6329679, e-mail: heinrich.mattle@insel.ch, CH;(2) Department of Neuroradiology, Inselspital, 3010 Bern, Switzerland, CH |
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Abstract: | We compared three angiographic methods for grading of carotid stenosis and examined the correlation between angiographic
and ultrasound findings. Two observers independently measured 111 carotid stenoses on arteriographic films of 84 patients.
The stenoses were graded according to the European Carotid Surgery Trial (ECST), North American Symptomatic Carotid Endarterectomy
Trial (NASCET), and Common Carotid (CC) methods. The results obtained by these methods were compared, and the interobserver
reproducibility of the measurements was calculated. In addition, all angiographic results were compared to ultrasound findings
obtained before angiography. Measurements using the CC method were the most reproducible and those using the NASCET method
the least. The NASCET method underestimated the degree of stenosis compared to the other methods. The ECST and CC methods
yielded almost identical results (97% agreement). Ultrasound provided an accuracy of 94% compared to ECST and CC methods and
84% compared to the NASCET method. Interobserver reproducibility of angiographic quantification of carotid stenoses was best
for the CC and ECST methods and least for the NASCET method. Ultrasound demonstrated better accuracy than the ECST and CC
methods.
Received: 7 April 1999/Received in revised form: 5 October 1999/Accepted: 11 April 2000 |
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Keywords: | Carotid stenosis Angiography Ultrasound |
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