Utility of Vertebral Duplex Scanning

Author： Andrews L. Beatty A. Gaudreau J. Horowitz S.

Publisher： Society for Vascular Ultrasound

ISSN： 1539-5898

Source： Journal of Vascular Technology, Vol.21, Iss.3, 1997-09, pp. : 163-165

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Abstract

Duplex scanning of the vertebral arteries is considered by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) to be a standard part of a complete carotid examination in all patients. These studies add time and complexity to the test procedure. We have not found the additional information to be clinically useful in our laboratory. Does the vertebral duplex scan benefit the patient? With current healthcare trends demanding increasing efficiency along with cost containment, we decided to study the utility of vertebral duplex scanning by ultrasonic colorflow imaging and doppler.One hundred consecutive patients were analyzed. They were categorized according to the following symptoms: asymptomatic, dizziness, posterior circulation symptoms, syncope, and nonlocalizing symptoms. Patients who were symptomatic also had transcranial Doppler (TCD) of the more distal posterior circulation. The presence of abnormality by duplex was very low (1%) in asymptomatic patients and 5% in symptomatic patients. Twenty-five percent of those symptomatic patients who underwent TCD had abnormal results. To verify our results, a second group of 100 patients was studied, and again, the yield of abnormality in asymptomatic patients was 1%.We conclude that it is not clinically helpful to perform studies of the vertebral vessels in all patients. In symptomatic patients, both duplex colorflow imaging and Doppler, as well as transcranial doppler of the distal posterior circulation, should be performed.