Pocket Sized Carotid Stenosis Screening by Junior Doctors

Not yet recruiting

Phase N/A Results N/A

Trial Description

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.

Detailed Description

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
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

Conditions

Interventions

  • Bed-side pocket size ultrasound imaging Procedure
    Other Names: GE Ultrasound V-scan Duo probe
    ARM 1: Kind: Experimental
    Label: Bed-side pocket-size ultrasound
    Description: All participants will be examined bed-side by pocket size ultrasound for the assessment of the carotid arteries by junior doctors. All participants will then be examined by reference imaging in specific ultrasound laboratories with conventional high end equipment and new doppler techniques and when appropriate computer tomography or magnetic resonance imaging.
  • High frame rate tracking doppler Procedure
    Other Names: Verasonics research scanner
    ARM 1: Kind: Experimental
    Label: Bed-side pocket-size ultrasound
    Description: All participants will be examined bed-side by pocket size ultrasound for the assessment of the carotid arteries by junior doctors. All participants will then be examined by reference imaging in specific ultrasound laboratories with conventional high end equipment and new doppler techniques and when appropriate computer tomography or magnetic resonance imaging.

Outcomes

Type Measure Time Frame Safety Issue
Primary Proportion of patients without need for further diagnostic imaging The participants will be followed for the duration of hospital stay, an expected average of approximately 4 days
Secondary Reliability of bed-side ultrasound examinations of the carotid arteries performed by junior doctors with pocket-sized scanners The participants will be followed for the duration of hospital stay, an expected average of approximately 4 days
Secondary Proportion of interpretable examinations with bed-side ultrasound examinations of the carotid arteries performed by junior doctors with pocket-sized scanners The participants will be followed for the duration of hospital stay, an expected average of approximately 4 days
Secondary Time use of junior doctors performing carotid ultrasound with pocket-sized scanners. The participants will be followed for the duration of hospital stay, an expected average of approximately 4 days
Secondary Accuracy of high frame rate tracking doppler compared to conventional doppler measurements and computed tomography for grading carotid stenosis. The participants will be followed for the duration of hospital stay, an expected average of approximately 4 days

Sponsors