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AJNR - American Journal of Neuroradiology

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Evaluation of Distal Extracranial Internal Carotid Artery by Transoral Carotid Ultrasonography in Patients with Severe Carotid Stenosis

Kazuhiro Kishikawa^a, Masahiro Kamouchi^a, Yasushi Okada^a, Tooru Inoue^b, Setsuro Ibayashi^c and Mitsuo Iida^c

^a Department of Cerebrovascular Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
^b Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
^c Department of National Kyushu Medical Center, and the Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

View larger version (64K): [in a new window]   FIG 1. Angiographic and ultrasonographic findings of carotid arteries before (left panels) and after (right panels) CEA. Arrowheads indicate severe stenosis in the origin of the ICA. Note that the distal ICA dilated after CEA. A, Angiographic findings before CEA. B, TOCU findings before CEA. C, Conventional carotid ultrasonographic findings before CEA. D, Angiographic findings after CEA. E, Transoral carotic ultrasonographic findings after CEA. F, Conventional carotd ultrasonographic findings after CEA.

View larger version (15K): [in a new window]   FIG 2. Diameter of the distal ICA before and after CEA is plotted. Diameter was measured intraorally at the level of the post-pharyngeal portion by using TOCU. Closed circles and error bars indicate mean ± SD.

View larger version (20K): [in a new window]   FIG 3. Comparison of the percent increase in the diameter of the distal ICA as estimated by TOCU and cerebral angiography.

View larger version (16K): [in a new window]   FIG 4. Relationship between degree of carotid stenosis and postoperative dilatation of the ICA. Percent increase in the diameter of the distal ICA was plotted against the grade of carotid stenosis. Grade of carotid stenosis in a cross-sectional area was estimated by conventional carotid ultrasonography. Diameter of the distal ICA was estimated by TOCU. Dotted line indicates 95% stenosis.

View larger version (14K): [in a new window]   FIG 5. Relationship between preoperative diameter and postoperative dilatation of the ICA. Percent increase in the diameter of the distal ICA was plotted against the preoperative diameter of the distal ICA. Diameter of the distal ICA was estimated by TOCU. Dotted line indicates diameter of 3.0 mm.