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The specimens from 116 consecutive carotid thrombendarterectomies were taken as "gold standard" to evaluate the accuracy of ultrasound methods (duplex scanning + extra-/transcranial Doppler sonography) and intravenous digital subtraction angiography (i.v. DSA) in carotid artery stenoses. In 65 cases, in which the specimens could be gauged reliably, sonography estimated the degree of stenosis in 85% within a range of +/- 10%, in 97% within +/- 20% i.v. DSA was accurate in 52 respectively in 94%. High-grade stenoses were correctly assessed by ultrasound in 90%, by i.v. DSA in 64%. Sonography identified 4/10 kinkings and coilings of the carotid artery, i.v. DSA 9/10. Current available ultrasound methods enable estimation of the diameter reduction of carotid artery stenoses with low deviations. I.v. DSA seems to be less reliable, but can be used favourably as a complementary method to sonography.
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I P Arlart
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