[Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography]. / Validación del estudio ultrasonológico de troncos supraaórticos en el diagnóstico de la enfermedad aterosclerótica de la arteria carótida interna. Comparación de los resultados con los de angiografía.

INTRODUCTION: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. OBJECTIVES: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. MATERIAL AND METHODS: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. RESULTS: A total of 254 carotids were evaluated and the degree of stenosis being classified into > 50%, 70-99% and 100%. The UST for the first group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had an Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. CONCLUSIONS: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis.

Validación del estudio ultrasonológico de troncos supraaórticos en el diagnóstico de la enfermedad aterosclerótica de la arteria carótida interna. Comparación de los resultados con los de angiografía / Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography

Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantificación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasificando el grado de estenosis en > 50%, 70-99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especificidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea (AU)

Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objetives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into > 50%, 70-99% and 100%. The UST for the first group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had an Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis (AU)

Angioplastia con prótesis endovascular en un caso de isquemia cerebral recurrente por estenosis de la arteria cerebral media / Angioplasty with stenting in a case of recurrent cerebral ischemia due to middle cerebral artery stenosis

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