{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:09:09Z","timestamp":1781539749789,"version":"3.54.5"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Diagnosing carotid near-occlusion (CNO) with colour duplex ultrasound (CDU) is challenging. We hypothesised that CNO is associated with a reduced distal internal carotid artery (ICA) velocity and aimed to assess if distal velocity is able to diagnose CNO accurately. If not, we aimed to develop CDU rule-out and rule-in criteria to diagnose CNO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a prospective cross-sectional study in consecutive participants with suspected\u2009\u2265\u200950% carotid stenosis on CT angiography (CTA). CDU velocities in the common carotid artery, the stenosis and distal to the stenosis were examined. CTAs were assessed for CNO, serving as a reference test. If no CDU parameter was both sensitive and specific for CNO, rule-out (98% sensitive) and rule-in (99% specific) criteria were created.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 315 included participants with \u2265\u200950% stenosis, 190 (60%) were conventional\u2009\u2265\u200950% stenosis and 125 (40%) CNO. No CDU parameter was both sensitive and specific for CNO. The best exclusion criteria were stenosis end diastolic velocity (EDV)\u2009\u2264\u200963\u00a0cm\/s and\/or distal peak systolic velocity (PSV)\u2009&gt;\u200923\u00a0cm\/s, seen in 115 (38%) participants. The best rule-in criteria were stenosis EDV\u2009\u2265\u2009280\u00a0cm\/s and\/or distal PSV\u2009\u2264\u200923\u00a0cm\/s, seen in 35 (12%) participants. Of the remaining participants, 143 (47%) were uncertain (74 CNOs) and 9 (3%) were misdiagnosed as carotid occlusion (all CNOs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>CDU alone cannot diagnose CNO but can rule in or rule out CNO in half of participants with \u2265\u200950% stenosis. These criteria are intended for inclusion in an algorithm, sorting cases needing further exams, such as CTA and\/or phase-contrast magnetic resonance angiography.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00234-025-03612-2","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T11:07:31Z","timestamp":1744801651000},"page":"1223-1231","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rule-out and rule-in of carotid near-occlusion using color duplex ultrasound"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-8392","authenticated-orcid":false,"given":"Johan","family":"Skoog","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Vanoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Henze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J.","family":"Fox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"issue":"8","key":"3612_CR1","first-page":"2086","volume":"26","author":"AJ Fox","year":"2005","unstructured":"Fox AJ, Eliasziw M, Rothwell PM, Schmidt MH, Warlow CP, Barnett HJ (2005) Identification, prognosis, and management of patients with carotid artery near occlusion. 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