Carotid Stenosis: Utility of Diagnostic Angiography

Objective Carotid artery stenosisis frequently diagnosed through screening tests with noninvasive imaging. Because of differences noted between the various modalities, we sought to investigate our experience comparing noninvasive imaging ( ultrasound, computed tomography angiography, magnetic resonance angiography) with invasive imaging ( digital subtraction angiography). Methods In a multicenter retrospective analysis, 249 carotid vesselswere reviewed based on angiographywith the associated noninvasive imaging. Results Overall, medical or surgical decision managementwas changed in 43% (107/243) of cases investigated with digital subtraction angiographyowing to a discrepancy between the measured percentage stenosis. In patients with potentially treatable carotid stenosis, angiographyrevealed nonsignificant stenosis25.7% of the time. Conclusions Angiographyshould be considered the confirmatory test for degree of stenosisin certain patients before definitive surgical treatment.