Carotid Artery Disease Spectrum on Carotid Doppler Sonography: An Experience at Tertiary Cardiac Care Center

Abstract

Objective: To assess the carotid artery disease spectrum in patients with coronary artery stenosis who underwent Carotid
Doppler studies.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Radiology department, AFIC/NIHD, Rawalpindi Pakistan from Jan 2018 to Jul 2019.

Methodology: Doppler ultrasound study of both carotid arteries was done in consecutive patients. All participants regardless of age and gender underwent carotid doppler assessment for the site of carotid plaque and percentage of stenosis. Data was grouped into two categories based upon Carotid Doppler outcomes such as; insignificant findings and significant findings. Insignificant findings comprised of no plaque or insignificant plaque with intima-media thickness (≤1.1mm), peak systolic velocity (<125cm/s), end-diastolic velocity (<40cm/s) and <50% narrowing of carotid arteries. Findings in which intimamedia thickness was >1.1mm, peak systolic velocity (>125cm/s), end-diastolic velocity (>40cm/s) and >50% carotid stenosis were represented as significant Doppler outcomes. Pearson Chi-square test was applied by using SPSS-26:00.

Results: Total n=654 patients were included. Normal carotid doppler outcome was seen in 290(43.4%) patients, while
350(53.5%) had insignificant findings and 20(3.1%) had significant findings. The commonest lesion found was the
atherosclerotic plaque and most frequently present in the left carotid system 392(60.0%) while most common site of plaque
presence was at carotid bifurcation 218(33.3%). Significant association of plaque site and plaque type with carotid doppler
outcomes was found (p<0.001).

Conclusion: Carotid artery disease is common on routine ultrasonic assessment. Carotid bifurcation was the most common
site of plaque while the left internal carotid artery was the,,,,,,,,,