The role of carotid ultrasound in patients with non-lateralizing neurological complaints

In the United States, approximately 18-25% of carotid duplex ultrasound (CUS) studies are ordered to assess patients with non-lateralizing neurological complaints such as syncope, blurry vision, lightheadedness, headache, and altered mental status. The purpose of this study is to evaluate the benefi...

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Bibliographic Details
Published in:Hospital practice (1995) 2023, Vol.51 (1), p.44-50
Main Authors: Varade, Shweta, Ravichandran, Abinayaa, Rehim, Erafat, Yacoub, Hussam, Duncan, Rose, Kincaid, Hope, Leary, Megan C, Castaldo, John
Format: Article
Language:English
Subjects:
Carotid Stenosis - complications
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - epidemiology
Constriction, Pathologic - complications
Humans
Retrospective Studies
Ultrasonography, Carotid Arteries
Ultrasonography, Doppler, Duplex
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Summary:In the United States, approximately 18-25% of carotid duplex ultrasound (CUS) studies are ordered to assess patients with non-lateralizing neurological complaints such as syncope, blurry vision, lightheadedness, headache, and altered mental status. The purpose of this study is to evaluate the benefit of CUS in the evaluation of patients presenting with non-lateralizing signs or symptoms. We conducted a retrospective analysis to assess the degree and laterality of carotid stenosis among patients with non-lateralizing neurological complaints who underwent CUS interpreted by certified vascular neurologists over a period of 3 years. The primary endpoint was to identify the prevalence of moderate-to-severe carotid artery stenosis among 280 patients who met inclusion criteria. A total of 17.7% of CUS studies were ordered for non-lateralizing symptoms. Two hundred and sixty-one patients (93.21%) had either normal imaging or mild carotid stenosis of 70% underwent a revascularization procedure. At least 17.7% of CUS studies were completed for non-lateralizing symptoms. The study is of low-yield with the prevalence of moderate-to-severe stenosis being comparable to that in the general asymptomatic population. We conclude that there is minimal clinical value in the use of CUS to investigate non-lateralizing neurological complaints, resulting in unnecessary healthcare costs.
ISSN:2154-8331
2377-1003
DOI:10.1080/21548331.2022.2144066