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Intraoperative Ultrasound Assessment of Carotid Endarterectomy and Carotid Stent Angioplasty

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Noninvasive Vascular Diagnosis

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Abstract

The historically good clinical outcomes associated with carotid intervention depend on proper patient selection and the technical precision of the procedure. Ultrasonography provides an instrument for quality control following carotid intervention. Duplex ultrasound provides both anatomic (real-time B-mode imaging) and hemodynamic (pulsed Doppler spectral analysis) assessment of the repair allowing detection of residual stenosis, lumen debris, plaque dissection, and arterial injury. The imaging modality also provides verification of patency and documents normal low resistance flow pattern in the distal internal carotid artery. Similarly, intravascular ultrasound (IVUS) is ideally suited for monitoring carotid stent-angioplasty as this monorail catheter platform provides high-definition real-time imaging of the extracranial carotid arteries allowing for calculation of vessel diameter, selection of stent landing zones, and monitoring the procedural accuracy of stent deployment. Procedural ultrasound imaging will identify abnormalities that should be corrected in approximately 5–10% of cases. Detection and immediate repair of carotid abnormalities is associated with improved clinical outcomes similar to reconstructions judged “normal” on initial ultrasound assessment thereby offering a margin of quality assurance for these interventions even in high-risk surgical candidates.

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Author information

Authors and Affiliations

  1. James A. Haley Veterans Hospital, Vascular Surgery Section, Tampa, FL, USA

    Paul A. Armstrong

  2. Division of Vascular and Endovascular Surgery, Department of Surgery, University of South Florida, Tampa, FL, USA

    Mary E. Ottinger

  3. Division of Vascular and Endovascular Surgery, University of South Florida, Tampa, FL, USA

    Christine Jokisch

Authors
  1. Paul A. Armstrong
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  2. Mary E. Ottinger
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  3. Christine Jokisch
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Corresponding author

Correspondence to Paul A. Armstrong .

Editor information

Editors and Affiliations

  1. Department of Surgery Division of Vascular/Endovascular Surgery, West Virginia University – Charleston Division, Charleston, WV, USA

    Ali F. AbuRahma

  2. Department of Surgery, Division of Vascular Surgery and Endovascular Therapy The John Hopkins University School of Medicine, Baltimore, MD, USA

    Bruce A. Perler

Section Editor information

  1. Department of Surgery, Division of Vascular/Endovascular Surgery, West Virginia University - Charleston Division, Charleston, WV, USA

    Ali F. AbuRahma M.D.

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Armstrong, P.A., Ottinger, M.E., Jokisch, C. (2022). Intraoperative Ultrasound Assessment of Carotid Endarterectomy and Carotid Stent Angioplasty. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-60626-8_11

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  • DOI: https://doi.org/10.1007/978-3-030-60626-8_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-60625-1

  • Online ISBN: 978-3-030-60626-8

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