Zachary C. Schmittling, MD, Robert B. McLafferty, MD, Jeffrey S

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Presentation transcript:

The inaccuracy of simple visual interpretation for measurement of carotid stenosis by arteriography Zachary C. Schmittling, MD, Robert B. McLafferty, MD, Jeffrey S. Danetz, MD, Syed M. Hussain, MD, Don E. Ramsey, MD, Kim J. Hodgson, MD Journal of Vascular Surgery Volume 42, Issue 1, Pages 62-66 (July 2005) DOI: 10.1016/j.jvs.2005.03.028 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 An illustration of how interobserver variability can occur. Vascular surgeon 1(VS1) (straight line) measured the stenotic area in a different portion of the artery than did VS2 (dotted line). More important, VS2 used a portion of the internal carotid artery for reference closer to the stenosis than did VS1. This led to VS1 reading this stenosis as 48% compared with VS2, who obtained a 73% stenosis. Journal of Vascular Surgery 2005 42, 62-66DOI: (10.1016/j.jvs.2005.03.028) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Patient underwent carotid arteriography for symptomatic cerebrovascular disease with history of a right-sided transient ischemic attack. The original degree of stenosis by visual interpretation was determined to be 80% to 85%. A digital caliber program and the North American Symptomatic Carotid Endarterectomy Trial Collaborators formula were used to calculate a corrected stenosis of 50%. Measurement numbers represent pixel lengths from the digital caliper program. Journal of Vascular Surgery 2005 42, 62-66DOI: (10.1016/j.jvs.2005.03.028) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Patient underwent carotid arteriography for asymptomatic stenosis found by Duplex ultrasound scanning. The original visual interpretation of this lesion was given as a 75%. A digital caliber program and the North American Symptomatic Carotid Endarterectomy Trial Collaborators formula were used to calculate a corrected stenosis of 42%. Measurement numbers represent pixel lengths from the digital caliper program. Journal of Vascular Surgery 2005 42, 62-66DOI: (10.1016/j.jvs.2005.03.028) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions