Pocket Sized Carotid Stenosis Screening by Junior Doctors
Pocket Sized Carotid Stenosis Screening by Junior Doctors
Among patients admitted with cerebral ischemia (stroke and transitory ischemic attack (TIA))
 it is important to reveal the underlying cause of the disease. In special it is important to
 reveal if carotid artery stenosis is present as such a finding will directly influence on
 treatment and follow-up.

 For the diagnosis of carotid artery stenosis due to atherosclerosis ultrasound examinations
 is the cornerstone, but computer tomography and magnetic resonance imaging may be better in
 some cases. Development of high quality pocket-sized ultrasound scanners has allowed for semi
 quantitatively bed-side assessment of the carotid arteries and the heart.

 The investigators aim to study the feasibility and reliability of bed-side assessment of the
 carotid arteries by pocket-sized ultrasound scanners in inexperienced hands and the clinical
 influence of this examination when performed by experienced users.

 The investigators hypothesize that a significant proportion of this patient population can be
 clarified bed-side by junior doctors with no need of further imaging procedures for the
 assessment of the carotid arteries and the heart.
Population: Approximately 100 patients admitted to the Department of Medicine, Levanger
 Hospital and Stroke Department, St. Olavs Hospital with history and findings suspicious of
 stroke/transitory ischemic attack (TIA). Informed consent mandatory.

 Exclusion criteria: CT angiography of carotid vessels performed after index event, unless all
 participating clinicians are fully blinded to the results.

 Hypotheses:

 The carotid arteries can be assessed bed-side by pocket-size ultrasound scanners with high
 feasibility and reliability by junior doctors with limited training.

 Bed-side assessment of the carotid arteries by pocket-size ultrasound scanners may reduce the
 need for more advanced (higher cost) imaging procedures.

 New high frame rate tracking doppler can increase accuracy and reproducability of stenosis
 grading.

 Methods:

 Pocket-size imaging device from GE Ultrasound, commercial available. Approved for clinical
 use. High-end carotid Doppler ultrasound by high-end equipment (GE Vivid 9) and computer
 tomography and magnetic resonance imaging at the Department of Radiology, Levanger Hospital
 and St. Olavs Hospital Verasonics research scanner for high fram rate imaging
Inclusion Criteria:

 -  Admitted to the Department of Medicine with history and findings suspicious of
 (transient) cerebrovascular ischemia and willing and able to give their informed
 written consent

 Exclusion Criteria:

 -  Evaluation of carotid artery stenosis by imaging (CT, MRI or ultrasound) performed
 during the stay prior to inclusion.