Abstract 8918: Diagnostic Criteria for Ultrasound Diagnosis of Internal Carotid Artery Stenosis Vary Widely Among Accredited Vascular Laboratories. A Survey from the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)

• DOI: 10.1161/circ.124.suppl_21.a8918
• Publication Date: 2024-04-23T09:55:19Z
• Authors: Heather L Gornik; Marge Hutchisson; Mariam Khan; James F Benenati; Michael R Jaff; Sandra Katanick; Laurence Needleman

Background: Carotid duplex ultrasound (DUS) is widely used for diagnosis of internal carotid artery (ICA) stenosis and therapeutic decisions are often on the basis DUS findings. There no universal standard criteria to grade severity ICA stenosis. A 2003 publication from Society Radiologists in Ultrasound (SRU) provided consensus grading stenosis, but their integration into clinical practice unknown. Methods: Random sample 10% vascular laboratories accredited extracranial testing. Data were abstracted ICAVL database, including most recent accreditation application. single reviewer (HLG) compared laboratory diagnostic published references. Results: 152 sampled, 57.2% which outpatient based. Mean annual volume 1,330 + 124.1 studies (range 100-9,858). 17 use among 117 labs with remaining facilities utilizing locally developed (6 labs) or unreferenced hybrid (29 labs). number categories was 5.80 .084 3-12). Cut-points mildest disease stratum ranged 0 0-60% normal 0% commonly reported (67.1% The cut-point severe (non-occlusive) 70 91% 80% (64.5% SRU consensus-based only 27.0% laboratories, although there a statistically significant increase utilization after versus before 2005 (50.0% vs. 18.8%, P <0.001). Despite divergent cut-points, self-reported accuracy correlation high (mean 85.8 0.65%). Conclusion: Diagnostic cut-points using vary laboratories. this, acceptable. Uptake has been limited, more common recently facilities. Health care providers must be aware lab-to-lab variation reporting while further efforts achieve considered by professional societies.