Carotid doppler ultrasound results

[stang66]

Last July 2012 I had a carotid doppler ultrasound done with the following results:

Right Carotid:  There is intimal thickening of the bifurcation extending into the external carotid artery.  Peak systolic is 100 cm/sec. Peak diastolic is 33 cm/sec.  No significant plaque formation not id there evidence of focal stenosis.

Left Carotid:  The intimal thickening along the common carotid artery through the bifurcation into the internal caotid artery is identified with some calcified and soft plaque present.  There is narrowing of less than 50%.  Peak systolic is 123 cm/sec.  Peak diastolic is 37 cm/sec.

Both vertebrats are visualized with cephalic flow.

Impression:  Bilateral thickening with developing plaque in the left carotid system but no significant stenotic lesion seen with areas of narrowing on the lest less than 50%


I am a 74 old male in excellent health and do not take any RXs. My primary care doc requested I do another carotid Doppler but the imaging folks tell me that medicare will not pay for it.  It cost $700.  Any comments/suggestions on the above report and/or need for another test. .  

[stang66]

Thanks once again for your prompt answer!  If there is any info I can give you in return from the USA, please let me know.  I wish you the best  in all your future endeavors. Best regards.

[Paderla Anitha, DNB]

Hi, you have two normal findings, the less than 50% stenosis and the PCV. And yes, the one positive finding is the intimal thickening. Regards.

[stang66]

Again, thanks for the informative reply.  If I understand your latest response, it tells me that since I do have a intimal thickening (even with a
less than 125 ICA PSV which is considered normal) this is a positive findings and not within the normal range.   Is this how I should interpret your response?

[Paderla Anitha, DNB]

Hi there, yes less than 50% means between 0-50%. As for the peak systolic velocity (PSV), it is considered normal when ICA PSV is less than 125 cm/sec and no plaque or intimal thickening is visible. The value mentioned in your report is 123. So, your report does state less than 50% stenosis and a PSV of 123. The positive finding is the intimal thickening. You can discuss this with your doctor to clear your doubts and then decide if you need to take the scan now. In the meantime follow the healthy lifestyle, it will prevent atherosclerosis. Regards.

[stang66]

Thanks for the reply!  I am on a 81mg aspirin each day.  As a matter of info, I exercise each day, maintain an ideal weight, take no RXs, eat right, and all my blood tests results are excellent.  I was considering having the tests done even if I had to pay the $689.00 US dollars for the test.  However, based on your reply, I believe I will have the test done at a later date.  Based on some research I did on this subject,  I am under the impression that when the report states that the narrowing is less than 50% it means the narrowing is between 0 and 50%.  Is my impression correct?

If possible, I would very much appreciate your comments on the peak systolic and diastolic cm/sec numbers I cited in my original posting.

Again, thanks for taking the time to answer my questions!

[Paderla Anitha, DNB]

Hi, according to studies done, if the stenosis is less than 50%, no further imaging is likely needed. Have you been initiated on Aspirin? As you do not have symptoms now, you can continue with aspirin if initiated and focus on controlling any risk factors you have like hypertension or diabetes or hyperlipidemia. You can postpone the follow up imaging studies till you come in the scope for medicare insurance eligibility. Take care.