Carotid Artery Stenosis: Likelihood Ratios

Introduction: Plaque in the carotid artery can cause stenosis leading to hemodynamic compromise. This is clinically relevant mostly as it applies to an increased risk of Stroke, which can be reduced by a carotid endarterectomy in certain indications (i.e. with a threshold degree of stenosis).

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The likelihood ratios of findings for Carotid Artery Stenosis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Carotid Bruit Duplicate	3.7	0.4	>50% stenosis. in patients referred for carotid ultrasound (bias?) Study: BMC Neurol. 2008 Jun 24;8:23. PMID: 18577216
Doppler Ultrasound	2.1	0.5	carotid doppler evaluating Peak Systolic Velocity (PSV), for criteria consistent with >70% stenosis. data from NASCET trial Study: Stroke. 1995 Oct;26(10):1747-52. PMID: 7570719

Good Positive Likelihood Ratio

Finding	+LR	-LR	Comments, Study
Carotid Bruit Duplicate	5.6	0.8	for stenosis >50%. in asymptomatic patients undergoing CABG Study: Int J Cardiol. 2006 Feb 15;107(2):225-9 PMID: 16412801

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Carotid Bruit Duplicate	1.6	0.6	stenosis >70%. symptomatic patients (TIA or stroke) Study: Ann Intern Med. 1994 Apr 15;120(8):633-7. PMID: 8135446