Assessment of ≥50% and <50% Intracranial Stenoses by Transcranial Color-Coded Duplex Sonography

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Abstract
Background and Purpose —A favorable risk-benefit ratio for warfarin compared with aspirin has been reported for the prevention of major vascular events in symptomatic ≥50% intracranial stenoses. Transcranial color-coded duplex sonography (TCCS) criteria providing an accurate detection of ≥50% and Methods —Prospectively collected TCCS, extracranial color-coded duplex sonography, and intra-arterial digital subtraction angiography data of 310 patients were reviewed. The patients had angiography for confirmation of symptomatic extracranial ≥70% carotid stenoses, symptomatic stenoses (peak systolic velocity higher than the corresponding mean value +2 SDs of 104 normal subjects), and occlusions of the middle cerebral or basilar artery previously assessed by ultrasound. The sonographer was not aware of angiographic findings. Results —TCCS would have detected all 31 of ≥50% intracranial stenoses with 1 false-positive and 35 of 38 Conclusions —TCCS may reliably assess ≥50% and <50% basal cerebral artery narrowing and prove useful for noninvasive management of patients with symptomatic intracranial stenoses.