HFUS detects major defects after CEA with no findings on angio


This carotid endarterectomy (CEA) case from the CIDAC study illustrates how High-Frequency Ultrasound (HFUS) enables more correct detection of higher-grade defects than angiography after CEA. Please read the CIDAC study if you would like to know more about the use of HFUS vs. angio in CEA and how the defects were rated.

Patient information

83-year-old male with symptomatic 70% common carotid artery stenosis.

Hx: Coronary artery disease, biological aortic valve repair, spinal surgery, stroke 4 days before surgery.

Intraoperative completion control

An endarterectomy of the common carotid was performed using the eversion technique. A grade 3 defect was detected with HFUS. Video 1 shows a large mobile flap in the vessel. In comparison there were no findings on angio which was of suboptimal quality (see image 1).


Video 1: HFUS pre-revision

Based on the findings by HFUS, the flap was removed during revision. Transit Time Flow Measurement (TTFM) confirms adequate flow post revision with 352 mL/min with a PI of 1,3 (see image 2).

Technology used

Medistim MiraQTM Vascular System with L15 HFUS Imaging Probe, TTFM Probes, and angiography.


CIDAC study: “Prospective Comparison of Duplex Ultrasound and Angiography for Intraoperative Completion Studies after Carotid Endarterectomy.”

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.

Case Attachments