| Author Year | Population/setting | Mean/median age (range) | Female (%) | Symptomatic patients (%) | TIA(%) | Stroke subtypes | Reference standard | Method for measuring degree of stenosis | Stenosis defined as positive on reference standard | Prevalence of positive stenosis | Prevalence of occlusion | MRA method | Categorization of flow void | Cutoff for positive test by NASCET criteria | Number of arteries/patients | Indeterminate results | Sensitivity | Specificity | Positive LR | Negative LR | Quality | Comments |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Young 1994 | 70 consecutive patients with non-disabling stroke/TIA, > 30% stenosis on duplex ultrasound at a hospital in the UK | 62 (37-76) | 30% | 100% | 51% | Carotid territory only | Selective carotid DSA | Common carotid denominator | 70-99% | 41% (arteries) | 11% (arteries) | 2D & 3D TOF | 90% stenosis | 50% | 137 arteries | 1 | 90% (89%) | 95% (94%) | 19.83 (15.10) | 0.10 (0.12) | GOOD. One indeterminate result was excluded. | Figures in parentheses represent sensitivity, specificity, and LRs when indeterminate result is assumed to be false + or false - |
| Huston 1998 | 50 consecutive patients scheduled for angiography after CUS at a referral hospital in Minnesota | 70 (42-87) | 32% | Not reported | Not reported | Not reported | Selective carotid angiography | NASCET | 70-99% | 25% (arteries) | 10% (arteries) | 2D & 3D TOF | 98% stenosis | 70% | 100 arteries | Reported results indicate 3 arteries missing from analysis | 94% (86%) | 84% (78%) | 5.93 (4.27) | 0.07 (0.16) | FAIR. Discretionary subject selection. 3 arteries were missing from reported results. | Figures in parentheses represent sensitivity, specificity, and LRs when 3 missing results are assumed to be all false + or all false - |
| Sardanelli 1999 | 30 consecutive patients with symptoms of cerebrovascular disease, who had undergone DSA | 64.5 | 41% | 100% | Not reported | Not reported | Cerebral DSA | NASCET | 70-99% | 23% (arteries) | 10% (arteries) | 3D
TOF Gadolinium-enhanced | 99% stenosis | 70% | 60 arteries | None | 100% 100% | 85% 100% | 6.67 Infinite | 0.00 0.00 | FAIR. Moderate sample size. Discretionary subject
selection. No inter-rater reliability testing. | |
| Vanninen 1995 | 45 consecutive patients with carotid territory TIA or non-disabling stroke, referred for angiography | 58 (34-72) | 16% | 100% | Not reported | Not reported | Selective carotid DSA | NASCET | 70-99% | 14% (arteries) | Not reported | 3D TOF | 85% stenosis | 70% | 90 arteries | None | 93% | 95% | 17.64 | 0.08 | FAIR. Moderate sample size. Discretionary subject selection. | |
| Jackson 1998 | 50 consecutive patients referred for carotid angiography after CUS at a military hospital in Washington, DC | 69.5 | 28% | 76% | Not reported | Not reported | Conventional cerebral angiography and DSA | NASCET | 60-99% | 36% (arteries) | 6% (arteries) | 2D TOF | > 80% stenosis | 60% | 99 arteries | 1 indeterminate 5 missing from analysis | 85% (74%) | 70% (63%) | 2.87 (2.32) | 0.21 (0.37) | POOR. Moderate sample size. Discretionary subject selection. No inter-rater reliability testing. One indeterminate result was excluded. 5 arteries were missing from reported results. | Figures in parentheses represent sensitivity, specificity, and LRs when 6 missing results are assumed to be all false + or all false - |
| Riles 1992 | 41 patients referred for angiography due to symptoms or asymptomatic stenosis > 80% on CUS | 68 (44-87) | 48% | Not reported | Not reported | Not reported | Conventional selective carotid angiography or DSA | NASCET | 50-99% 80-99% | 60%
(arteries) 27% (arteries) | 7% (arteries) | 2D TOF | Not reported Not reported | 50% 80% | 75
arteries 75 arteries | None None | 100% 88% | 64% 88% | 2.78 7.33 | 0.00 0.14 | POOR. Moderate sample size. Discretionary subject
selection. No inter-rater reliability testing. Testing methods were not well described. Potential unblinding in some cases. |
TIA: transient ischemic attack; DSA; digital subtraction angiography; NASCET; North American Symptomatic Carotid ENdarterectomy Tial; CUS; carotid ultrasound; TOF; time-of-flight; 2D; two-dimensional; 3D; three dimensional; LR; likelihood ratio
From: Evidence Tables
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