I need help understanding my carotid study

[line]

Hello Dr.

I am a almost 65 year old female, no high b/p, cholestrol in normal range. I just received the results of my carotid duplex study, this is the 5th year in a row I had it done, due to minimal blockage.

right side

-----PSV-------- EDV
CCA -126cm/sec--32cm/sec
ICA--78---------35-----
ECA--150--------35-----

left side

CCA--130--------38-----
ICA--82---------24-----
ECA--136--------32-----

Impression:  right side. minimal and diffuse thickning of the common carotid. Somewhat calcific plaque is noted in the bifuurcation. Slight tortuosity is noted also.

left, essentailly the same.

Both vertabrals are patent with antegrade flow

16-49% bilaterial internal carotid disease both sides.

As I said this is my 5th study, my numbers change from year to year, higher or lower. How can the numbers change and you are still n the same percentile. Am I closer to the high end of the percentage or where? What caused the veins to twist or turn (tortuosity). This is the first time this was on my report.  The study was read by a vascular surgeon.

Thank you, Linda

[Firebird581]

A related discussion, aortic stenosis and carotid artery test was started.

[helpandgethelped]

Hello Line,

As a registered vascular technologist, I administer the carotid exam and can evaluate it. The main concern of the exam is the ICA/CCA ratio, that is divide your ICA velocity (right side 78) by your CCA velocity (right side 126) 78/126 = 0.62. same for your left side 82/130 = 0.63. These are both with in normal limits, WNL. You should be concerned when your ICA velocity begins to exceed your CCA velocity.

Concerning your vertebrals, antegrade flow simply means they are going in the right direction, towards the brain. FYI, retrograde flow would mean it is flowing in the wrong direction, away from the brain.

Other info: PSV= peak systolic velocity
            EDV= end diastolic velocity
            CCA= common carotid artery
            ICA= internal carotid artery
            ECA= external carotid artery

Hope this helps, MG

[CCF-Neuro-M.D.-PW]

Blood flow velocity (which is what the test measures) is not exactly constant every time you measure. THere will always be  a degree of variation. That is why centiles are used. Changes that affect blood velocity like hypertension, pregnancy, overactive thyroid, infection etc could affect the results to a certain extent. It is also comewhat test and interpreter dependent - no test will be exactly 100% the same each time.

I cannot interpret your velocities due to lack of information - I assume they are systolic pressures, no diastolic pressures are there ie 120/80, 82/?
the absolute velocties of the ICA look relatively good though. Tortuosity is fairly common especially in older people and is usually not though to be significant, especially if 'slight'

Good luck

[heart2heart]

I'm lucky they didn't find any blockages. I had this test done because I was having dizzy spells. But then, I'm 9 years younger than you...ugh...don't even talk to me about the "golden years" lol,,,something I'm not looking forward to.

[line]

My Dr. is just watching this and has me on 81 mgs of aspirin. I am curious to see where I am in the 16- 49% range.The report always says minimal, I always have my test done at the same place and the same vascular surgeon reads it. My G/P told me this is common to find blockage of some degee in seniors and sometimes never worsens. Do you have any blockage?

Gee tortousity as we age too, where are the golden years?

thanks for your input, Linda

[heart2heart]

As we age we may develop tortuous arteries. I have tortuous carotids also. This may be normal.

Patent vertebrals means your vertebral arteries are open.  Thats good news. You have some plaque in your carotids. I don't know what your doctor wants to do about it. You may not be a candidate for surgery at this point. Are you on any blood thinners?

This test is highly dependent on the person doing it. That is why the numbers may be different from year to year. But they shouldn't be that way off!  I had one test in my regular local hospital and got inconclusive results (they couln't find my bifurcation!)  I then went to a major academic hospital where they had 2 technicians (a student and a teacher!) doing it on me, and I'm satisfied with the results of the last test.

[heart2heart]

I forgot to answer your other question.  No, bone spurs are not the cause of your carotid artery problems. If bone spurs cause any problems it would be in the vertebral arteries with the spurs compressing the vertebral artery as it passes in the spinal canal. I've checked into this because I too have lots of bone spurs in my cervical spine. Carotid artery problems are usually caused by plaque buildup..ageing or high cholestral...of course smoking can accelerate any vascular problem.

[line]

I forgot to ask, I have a lot of cervicl issues as arthritis, bone spurs etc. Right now I am dealing with nerve  compression and have a lot of tingling in my neck and shoulder, can this effect the carotid study?

Thank you so much or your time, Linda