Feasibility and Clinical Impact of Point-of-Care Carotid Artery Examinations by Experts using Hand-Held Ultrasound Devices in Patients with Ischemic Stroke or Transitory Ischemic Attack
| Autor: | Hanne Ellekjær, Lars Molgaard Saxhaug, Øystein Olsen, Torbjørn Graven, Jens Olaf Kleinau, Håvard Dalen, Kyrre Skjetne |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Carotid arteries Point-of-Care Systems Young Adult Medical imaging medicine Humans In patient Carotid Stenosis cardiovascular diseases Stroke Point of care Aged Ischemic Stroke Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Rehabilitation Ultrasound Equipment Design Middle Aged medicine.disease Stenosis Carotid Arteries Ischemic Attack Transient Angiography Feasibility Studies Surgery Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | 30:106086 Journal of Stroke & Cerebrovascular Diseases |
| ISSN: | 1532-8511 |
| Popis: | Background and purpose To evaluate the feasibility and clinical influence of carotid artery examinations in patients admitted with stroke or TIA with hand-held ultrasound by experts, to identify individuals not in need of further carotid artery diagnostics. Materials and methods Cardiologists experienced in carotid ultrasound examined 80 patients admitted to a stroke unit with suspected stroke or TIA with hand-held ultrasound devices (HUD). Grey scale and color Doppler images were stored using a GE Vscan with dual probe (phased array and linear transducer). High-end triplex ultrasound performed by a cardiologist, blinded to the details of the HUD study, was performed in all patients and used as reference. Computer tomography angiography was performed when clinically indicated. Results Stroke or TIA was diagnosed in 62 (78%) patients. Age was median (range) 72 (23–93) years. A significant stenosis (> 50% diameter reduction) was ruled out in 61 (76%) of patients by the HUD examinations. Sensitivity and specificity for diagnosing a significant stenosis was 92% and 93%, respectively. One of 12 significant stenoses was missed by HUD. All four patients in need of surgery were identified by the HUD examination. Sensitivity and specificity to identify a significant stenosis by HUD was 87% and 83%, respectively, compared to CT angiography. Conclusion HUD examinations of the carotid arteries by experts, using hand-held ultrasound devices, were feasible and may reduce the need for high-end diagnostic imaging of the carotid vessels in patients with stroke and TIA. Thus, HUD may improve diagnostic workflow in stroke units in the future. |
| Databáze: | OpenAIRE |
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