Follow up of carotid artery stents; comparison of B-flow and doppler sonography.

SUMMARY:PURPOSE: To evaluate the neointimal proliferation after carotid stenting and compare theeffectiveness of color, power Doppler and B-Flow sonographyMATER ALS AND METHODS: After carotid stenting, 34 patients(age range:54-77 years;mean age: 65.9±6.6) were followed up to 12 mounths with color, power Doppler and B-Flowsonography. Visibility of neointimal layer with different sonographics techniques were gradedby two experienced radiologist from static images obtained in longitudinal views. Statisticalcomparison was performed using Friedman and Wilcoxon tests. Also the area of the vessel lumenwas calculated with three different techniques and the mean values were compared with t-test.RESULTS: All of the stents remained patent during the follow-up period. Neointimalproliferation was between 0.6-2.6 mm.(mean: 1.2±0.5mm.). Statistical analysis with Friedmanand Wilcoxon tests revealed that B-Flow was superior to color and power Doppler sonographyfor the evaluation of visibility of neointimal proliferation (p=0.000). Kappa scores revealed fairto substantial interobserver aggrement(0.551-0.682). The mean vessel lumen areas werecalculated as 0.155, 0.145 and 0.127 cm² with color, power Doppler and B-Flow sonography,respectively. T-test showed significant difference between all techniques(p=0.000).CONCLUSION: B-Flow is superior to color and power Doppler sonography in the evaluation ofneointimal proliferation after carotid stenting. This technique avoids owerwriting of the vesselwall and provides simultaneous imaging of blood flow and vessel walls.