Need help with Results of carotid artery ultrasound

Posted by sandrajane @sandrajane, Jan 13 11:45am

This US was ordered by my ENT for tinnitus. . He reviewed
it and texted me today that there are no alarming issues noted. I did reply that I was concerned about the stenosis and the artheromateous disease,.
Should I be concerned that he is not concerned or is this a normal part of aging?
Narrative & Impression
General: A bilateral carotid duplex was performed.
Previous: No previous study.
Right: RIGHT: Doppler flow velocity represents ICA stenosis of 1-39%. Heterogeneous
plaque noted.
Proximal ICA PSV/EDV (highest) = 112/26.3cm/s
ICA/CCA ratio = 0.9
Antegrade vertebral artery flow noted.
Left: LEFT: Doppler flow velocity represents ICA stenosis of 1-39%. Heterogeneous
calcified plaque noted.
Mid ICA PSV/EDV (highest) = 106/31.4cm/s
ICA/CCA ratio = 1.0
Antegrade vertebral artery flow noted.
Conclusions
1. RIGHT ICA: 1-39% ICA stenosis - (Mild atheromatous disease).
2. LEFT ICA: 1-39% ICA stenosis - (Mild atheromatous disease).
3. Antegrade vertebral artery flow noted bilaterally.

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The degree of stenosis/atherosclerosis is moderate at the high end...although it depends on your age and sex maybe..? If you're under 30, it might indicate being watchful for the next 10 years. If you're over 60, whew! You're doing pretty well. Unless something is going on and the rate of deposition accelerates, or IS accelerating, you are probably not going to die from atherosclerotic disease.

The antegrade flow in the vertebral artery is what you want to see AFAIK:
https://www.ncbi.nlm.nih.gov/books/NBK570624/#:~:text=The%20flow%20in%20the%20vertebral%20artery%20should%20be,vessel%20with%20prominent%20diastolic%20flow%20and%20spectral%20broadening.

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Thank you. Senior here. I feel better. My flow was good I believe because it says antegrade vertical artery flow noted bilaterally

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@sandrajane

Thank you. Senior here. I feel better. My flow was good I believe because it says antegrade vertical artery flow noted bilaterally

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That means both sides, both carotids, have the type of flow they expect in 'normal' patients.

Bilateral = 'two sides.'

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I suppose I should suggest I’d be retested in a year or get the cardiac CT scan. I don’t know. I’m still a little worried about it because 1 to 39 is a big jump so I have no idea if it’s on the high end or the low end and how fast it’s going to build

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@gloaming

The degree of stenosis/atherosclerosis is moderate at the high end...although it depends on your age and sex maybe..? If you're under 30, it might indicate being watchful for the next 10 years. If you're over 60, whew! You're doing pretty well. Unless something is going on and the rate of deposition accelerates, or IS accelerating, you are probably not going to die from atherosclerotic disease.

The antegrade flow in the vertebral artery is what you want to see AFAIK:
https://www.ncbi.nlm.nih.gov/books/NBK570624/#:~:text=The%20flow%20in%20the%20vertebral%20artery%20should%20be,vessel%20with%20prominent%20diastolic%20flow%20and%20spectral%20broadening.

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I’ll look forward to reading that article. When I saw this thread title I went and got my report from my Carotid ultrasound done in May last year. My doctor’s office called and said no plaque, but I got the report just to see it for myself. It was signed by my dad’s former cardiologist.

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@celia16

I’ll look forward to reading that article. When I saw this thread title I went and got my report from my Carotid ultrasound done in May last year. My doctor’s office called and said no plaque, but I got the report just to see it for myself. It was signed by my dad’s former cardiologist.

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Did your report say plaque? What are you concerned about? I’m concerned my PA who is an ENT may not have the knowledge to be signing off on this. He never got back to me after I questioned the plaque on the report either.

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Just being overly cautious I suppose. I have health anxiety. So, even if I’m assured things ate fine, I still followup to confirm. I had the ultrasound after reporting intermittent neck pain to my primary, it must have been a strained muscle. It hasn’t returned.

My report looks pretty good. There is no % of stenosis, though I’m not sure what that means. I recall the tech who was administering the ultrasound commented that while she was not qualified to interpret the data, my tests were textbook normal based on her training, which I was glad to hear. Still, I was nervous waiting the results.

Since I have longterm tI diabetes, I live as if I have cardiovascular problem as a precaution.

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@celia16

Just being overly cautious I suppose. I have health anxiety. So, even if I’m assured things ate fine, I still followup to confirm. I had the ultrasound after reporting intermittent neck pain to my primary, it must have been a strained muscle. It hasn’t returned.

My report looks pretty good. There is no % of stenosis, though I’m not sure what that means. I recall the tech who was administering the ultrasound commented that while she was not qualified to interpret the data, my tests were textbook normal based on her training, which I was glad to hear. Still, I was nervous waiting the results.

Since I have longterm tI diabetes, I live as if I have cardiovascular problem as a precaution.

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Did your report look different from mine? No mention of Doppler flow velocity or percentage of stenosis? That’s weird.

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@sandrajane

I suppose I should suggest I’d be retested in a year or get the cardiac CT scan. I don’t know. I’m still a little worried about it because 1 to 39 is a big jump so I have no idea if it’s on the high end or the low end and how fast it’s going to build

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1-39 means you have a minimum of 1% and a max of 39%, not a jump from 1 to 39. My carotid ultrasound showed 1-15% on one side and 16-49% on the other. That was 4 years ago. A recent follow-up showed < 50% in both. The tech said that’s the new scoring and when he compared my current images to past there was little change. I have a friend who is a vascular surgeon and he told me most people in my age group (65-70) have some plaque in their arteries, I just happened to find out. Also I could have as little as 1% on one side and 15% on the other. He said it’s a poor way of scoring and hard to determine risk from that. He recommended
I step up my diet and exercise and stop worrying! Good luck to you😊

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@teris1

1-39 means you have a minimum of 1% and a max of 39%, not a jump from 1 to 39. My carotid ultrasound showed 1-15% on one side and 16-49% on the other. That was 4 years ago. A recent follow-up showed < 50% in both. The tech said that’s the new scoring and when he compared my current images to past there was little change. I have a friend who is a vascular surgeon and he told me most people in my age group (65-70) have some plaque in their arteries, I just happened to find out. Also I could have as little as 1% on one side and 15% on the other. He said it’s a poor way of scoring and hard to determine risk from that. He recommended
I step up my diet and exercise and stop worrying! Good luck to you😊

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It does sound like a very poor way of figuring out how much plaque we have and the need to decide on a statin, which I am pretty much very much against. Before I speak to my doctor, do you happen to know which is a better test to determine just how much plaque One has in their arteries? Thank you

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