This case illustrates how High-Frequency Ultrasound (HFUS) enables more correct detection of higher-grade defects than angiography after CEA. The case is provided by the authors of the CIDAC study.
Thrombus detected with HFUS after CEA
Case story
Patient information
83-year-old male, 90% left ICAS, 70% right ICAS
Intraoperative completion control with HFUS
An endarterectomy at the upper part of the internal carotid was performed. A grade 4 defect was detected with HFUS (Video 1), in comparison, angiography only showed a grade 2 defect (Image 2). The HFUS video clearly shows the thrombus in the lumen, visualized both by a cross-sectional and a longitudinal view. Based on the finding, a revision was performed and the thrombus was removed.
Post revision
A nice, clean lumen is seen after revision and Transit Time Flow Measurement was acceptable (Image 3 and 4).
Case attachments
Click images below to view.
HFUS showing a grade 4 defect
Angio showing only grade 2 defect
HFUS showing a clean lumen post revision
TTFM post revision
Reference
CIDAC study:
Christoph Knappich, Sofie Schmid, Pavlos Tsantilas, Michael Kallmayer, Michael Salvermoser, Alexander Zimmermann, Hans-Henning Eckstein *. Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. Eur J Vasc Endovasc Surg (2020) 59, 881- 889.
Technology used
Medistim MiraQ™ Vascular System with Vascular TTFM Probes and L15 High-Frequency Ultrasound Probe.
