{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T20:11:19Z","timestamp":1791058279764,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1996,4]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            The North American Symptomatic Carotid Endarterectomy Trial (NASCET) demonstrated the benefit of carotid endarterectomy for symptomatic patients with \u226570% carotid stenosis. Screening for detection of significant carotid occlusive disease has relied on duplex Doppler imaging. However, traditional duplex categories (50% to 79%, 80% to 99%) are not directly applicable to NASCET. We sought to evaluate duplex criteria for determination of \u226570% carotid stenosis.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            Duplex scans and arteriograms of 110 patients (210 carotids), performed within 1 month of each other, were reviewed by blinded readers. Arteriographic stenosis was determined by the NASCET method. Duplex measurements of peak systolic and end-diastolic velocity (PSV, EDV) were recorded, and ratios of velocities in the internal and common carotid arteries (ICA, CCA) were calculated. Receiver-operator characteristic (ROC) curves of sensitivity, specificity, positive and negative predictive values (PPV, NPV), and accuracy were determined.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Interobserver agreement for measurement of arteriographic stenosis was \u201calmost perfect\u201d (\u03ba=0.86). The criteria chosen for detection of \u226570% stenosis were PSV\n            <jats:sub>ICA<\/jats:sub>\n            &gt;210 cm\/s (sensitivity, 94%; specificity, 77%; PPV, 68%; NPV, 96%; accuracy, 83%), EDV\n            <jats:sub>ICA<\/jats:sub>\n            &gt;70 cm\/s (sensitivity, 92%; specificity, 60%; PPV, 73%; NPV, 86%; accuracy 77%), PSV\n            <jats:sub>ICA<\/jats:sub>\n            \/PSV\n            <jats:sub>CCA<\/jats:sub>\n            &gt;3.0 (sensitivity, 91%; specificity, 78%; PPV, 70%; NPV, 94%; accuracy, 83%), and EDV\n            <jats:sub>ICA<\/jats:sub>\n            \/EDV\n            <jats:sub>CCA<\/jats:sub>\n            &gt;3.3 (sensitivity, 100%; specificity, 65%; PPV, 65%; NPV, 100%; accuracy, 79%).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            We conclude that \u226570% carotid stenosis can be reliably determined by duplex Doppler ultrasound. Individual vascular laboratories must validate their own results.\n          <\/jats:p>","DOI":"10.1161\/01.str.27.4.695","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"695-699","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":119,"title":["Determination of Duplex Doppler Ultrasound Criteria Appropriate to the North American Symptomatic Carotid Endarterectomy Trial"],"prefix":"10.1161","volume":"27","author":[{"given":"Jeffrey P.","family":"Carpenter","sequence":"first","affiliation":[{"name":"From the Departments of Surgery (J.P.C., J.T.D.) and Radiology (F.J.L.), University of Pennsylvania School of Medicine, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Lexa","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery (J.P.C., J.T.D.) and Radiology (F.J.L.), University of Pennsylvania School of Medicine, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia T.","family":"Davis","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery (J.P.C., J.T.D.) and Radiology (F.J.L.), University of Pennsylvania School of Medicine, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_1_2_2","first-page":"373","volume":"1","year":"1982","unstructured":"Roederer GO, Langlois YE, Chan ATW, Primozich J, Lawrence RJ, Chikos PM, Strandness DE. Ultrasonic duplex scanning of the extracranial carotid arteries: improved accuracy using new features from the common carotid artery. J Cardiovasc Ultrasonography. 1982;1:373-380.","journal-title":"J Cardiovasc Ultrasonography"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92916-P"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(93)90019-I"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(94)90290-9"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.186.2.8421726"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.9.8362420"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)45046-2"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198807000-00013"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02016740"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02329382"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.1.8266380"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(94)70006-0"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.27.4.695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:36:24Z","timestamp":1715553384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.27.4.695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,4]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1996,4]]}},"alternative-id":["10.1161\/01.STR.27.4.695"],"URL":"https:\/\/doi.org\/10.1161\/01.str.27.4.695","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,4]]},"assertion":[{"value":"1995-08-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1995-12-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}