Case Study: Bilateral Bruit

Conclusion:
As seen in this case, 3D rendering is a valuable adjunct and enhances the capabilities of Carotid Duplex Ultrasound.

Discussion:
Patient anatomy may sometimes cause difficulty using Doppler, in this case giving lower readings. CTA is considered the gold standard, but requires justification for use. Doppler alone did not provide justification. Visualize:Vascular does. Pathology found during surgery confirmed that the patient did indeed have severe plaque buildup.

Patient:
71 year old male with bilateral Bruit and history of hyperlipidemia, hypertension, and is a former heavy cigarette smoker who stopped smoking in the 1980’s. The patient is currently using the following medications: Niaspan, Cardizem, Metropolol, Doxcyclomen, and Singulair. Patient does not have a history of TIA.



Ultrasound Results: NOT Significant concern
CDE Right ICA Systolic/Diastolic Right ICA Left ICA Systolic/Diastolic Left ICA
2/2011 244/72 50-69% 298/72 50-69%
6/2011 243/54 50-69% 289/59 50-69%

Visualize:Vascular Results: SIGNIFICANT concern on right
Visualize:
Vascular™
Right ICA
Luminal Reduction
Left ICA
Luminal Reduction
6/2011 78% 52%

CTA Results: CONFIRMS VISUALIZE:VASCULAR
CTA Right ICA
NASCET
Left ICA
NASCET
6/2011 >70% Not significant

Right ICA 3D View Left ICA 3D View