Peak Systolic Velocity (PSV) determines % of carotid blockage?

Question

The Peak Systolic Velocity (PSV) from an ultrasound is used to determine the % of a carotid artery blockage. Higher PSV means more blockages. However, a healthy small-frame person can have smaller carotid arteries relative to a bigger built person. Is this assumption correct? If yes, then isn’t a higher PSV expected for a smaller frame person? Any related articles would be appreciated.

Answer 1

i found these article related to your topic, however I think in analysing PSV in ultrasound we refer to patient gender and age, that is somehow reflect his/her body frame!

1: Diagn Interv Radiol. 2006 Sep;12(3):142-146.
Effects of overweight on luminal diameter, flow velocity and intima-media thickness of carotid arteries.
PURPOSE To the best of our knowledge, there are only a few previous studies on the effects of overweight on extracranial carotid arteries. We aimed to investigate the effects of overweight on flow velocities, luminal diameters and intima media thicknesses (IMTs) of the common and internal carotid arteries (CCA, ICA). MATERIALS AND METHODS A prospective study on color duplex sonography of the extracranial arteries was performed in 71 adults, ages between 25-58 years old. The body mass index (BMI) was found to be normal in 24 (group 1) and high in 47 (group 2) subjects of the study group. Flow velocity (FV), luminal diameter and IMT of carotid arteries of all the participants were measured. RESULTS There were significant differences between group 1 and group 2 in the following parameters; luminal diameters of the right CCAs were significantly larger in group 2, peak-systolic FV of ICAs were significantly lower in group 2 than in group 1 and ICA end-diastolic FVs were significantly lower in group 2 than in group 1. CONCLUSION The present data shows that there is a correlation among carotid artery luminal diameter, FVs and overweight. In the overweight subjects, the increased luminal diameter and decreased FVs can point at the early stage of atherosclerosis. The influence of adiposity on atherosclerosis is very complex and varies with gender and age, therefore we need larger series and further investigation.

PMID: 16972220 [PubMed - as supplied by publisher]
it has free full text you can use its refrences too.

2: J Vasc Surg. 2004 Nov;40(5):939-44.
Gender differences in blood velocities across carotid stenoses.Comerota AJ, Salles-Cunha SX, Daoud Y, Jones L, Beebe HG.
Jobst Vascular Center, Toledo, OH 43606, USA. [e-mail]

OBJECTIVES: Carotid duplex scanning is the standard test for documenting carotid disease. Carotid endarterectomy effectively reduces stroke in selected patients with carotid artery disease. Data from large national randomized trials suggest that the benefits of CEA may be gender dependent. Because many diagnoses are made and treatment is based on the results of carotid duplex ultrasound scanning alone, it is important to determine whether different diagnostic thresholds should be used in men and women. The purpose of this study was 2-fold: to examine whether there is an overall gender difference in carotid velocity at similar arteriographic stenoses, and to determine whether there are significant differences at clinically relevant thresholds of disease. METHODS: A database of 938 carotid arteriogram entries was established prospectively, with accompanying measurements of peak systolic velocity (PSV) and end-diastolic velocity (EDV). The percent of internal carotid artery stenosis seen on arteriograms was calculated according to criteria from the North American Symptomatic Carotid Endarterectomy Trial. Analyses were made in 536 carotid arteries in men and 402 carotid arteries in women. In addition, the single most diseased artery per patient was analyzed by gender. PSV and EDV were averaged for data subsets according to 10% intervals of internal carotid artery stenoses. Velocity for each interval was compared between men and women with the Student t test. Receiver operator characteristic curves were developed to define optimal duplex criteria for 60% and 70% stenosis. RESULTS: For all intervals, PSV and EDV averaged 9% and 6% higher, respectively, in women than in men. Significant gender differences existed between PSV and EDV for 60% and 70% stenosis (P = .03). When a single vessel per patient was analyzed these observations persisted, but lost significance for PSV at 60% stenosis (P = .18). Receiver operator characteristic curves at 90% sensitivity demonstrated that optimal PSV for 60% stenosis was 160 cm/s and 180 cm/s, and for 70% stenosis was 185 cm/s and 202 cm/s, in male and female patients, respectively. CONCLUSIONS: Women have higher carotid blood flow velocity than men do. Gender differences exist, and are notably different at clinically relevant thresholds for intervention. These data indicate that different criteria should be used for interpreting carotid velocity profiles in women than in men, and have potentially important implications for patient care.

PMID: 15557908 [PubMed - indexed for MEDLINE]

Answer 2

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Peak Systolic Velocity (PSV) determines % of carotid blockage?
The Peak Systolic Velocity (PSV) from an ultrasound is used to determine the % of a carotid artery blockage. Higher PSV means more blockages. However, a healthy small-frame person can have smaller carotid arteries relative to a bigger built person. Is this assumption correct? If yes, then isn’t a...

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