Vascular | The narrow truth: Carotids in crisis (cont.)
Tracks
Rm 7 | Virtual
Vascular
| Saturday, May 30, 2026 |
| 2:40 PM - 3:20 PM |
| Rm 7 | First Floor |
Speaker
Mr Matthew Le
Sonographer
South Australia Medical Imaging
Transcranial Doppler assessment for PFO detection
2:40 PM - 3:00 PMPresentation Synopsis / Abstract
Patent Foramen Ovale (PFO) is a common cardiac anomaly affecting approx 1 in 4 people. It is a significant risk factor for stroke due to paradoxical embolism.
Transcranial Doppler Ultrasound with agitated saline contrast (bubble test) is often a more sensitive compared to a Trans Oesophageal Echo and easier to obtain than a Trans Thoracic Echo.
The use of TCD PFO detection at the Royal Adelaide Hospital has changed the way strokes of Embolic Stroke of Underdetermined Source (ESUS) are managed in South Australia.
Learn about the RAH experience, how to perform a TCD bubble test and explore the range of pathologies encountered.
Transcranial Doppler Ultrasound with agitated saline contrast (bubble test) is often a more sensitive compared to a Trans Oesophageal Echo and easier to obtain than a Trans Thoracic Echo.
The use of TCD PFO detection at the Royal Adelaide Hospital has changed the way strokes of Embolic Stroke of Underdetermined Source (ESUS) are managed in South Australia.
Learn about the RAH experience, how to perform a TCD bubble test and explore the range of pathologies encountered.
Biography
Mr Matthew Le |
South Australia Medical Imaging
Matthew is the Head Sonographer of the Royal Adelaide Hospital, the largest tertiary hospital in South Australia. During his time there, he has implemented many new techniques into standard practice. These include Shearwave Elastography, Liver Fat Quantification, Transcranial Doppler for Vasospasm and Patent Foramen Ovale assessment, Intestinal ultrasound and Contrast Enhanced Ultrasound.
He is a passionate sonographer and takes joy in sonographer professional development and growth of the profession as a whole. He was also awarded the ASA Sonographer of the Year for South Australia in 2025.
Ms Sarah Park
Reporting Sonographer
Te Whatu Ora, Waikato
Can we screen patients for haemodynamically significant carotid stenosis in less than 4 minutes?
3:00 PM - 3:10 PMPresentation Synopsis / Abstract
Introduction: Carotid Doppler ultrasound is a common vascular examination that consumes significant time, resources, and costs. However, its diagnostic yield for surgically significant carotid stenosis is relatively low.
Objective: To develop a rapid carotid duplex protocol that begins with a simplified examination of the carotid arteries (B-mode and colour Doppler) and then adds additional imaging parameters (spectral Doppler) based on disease severity.
Methods: Patients referred for diagnostic carotid artery examination were invited to participate in the study. The results of the rapid examination were compared to the results of the traditional carotid duplex examination.
Results: Data from 250 patients (500 carotid arteries) were obtained. Patient age ranged from 23 to 92 years (median of 74 years). The traditional carotid examination was considered the gold standard and provided the following diagnoses for per carotid artery: normal (n=135, 27.0%), <50% stenosis (n=316, 63.2%), 50-59% stenosis (n=11, 2.2%), 60-69% stenosis (n=8, 1.6%), 70-79% stenosis (n=9, 1.8%), 80-89% stenosis (n=6, 1.2%), >90% stenosis (n=8, 1.6%), near occlusion (n=0, 0.0%), and occlusion (n=7, 1.4%). For the detection of 50-59% carotid artery stenosis, the rapid examination achieved sensitivity of 96.0% and specificity of 100.0%. For the detection of 60% carotid artery stenosis of any category, the rapid examination achieved 100% sensitivity and specificity. Time required to complete the rapid examination ranged from 21.2 seconds to 216.9 seconds.
Conclusion: The rapid examination is a novel screening test to exclude significant carotid artery stenosis, which can dramatically reduce examination time and cost without compromising diagnostic accuracy.
Objective: To develop a rapid carotid duplex protocol that begins with a simplified examination of the carotid arteries (B-mode and colour Doppler) and then adds additional imaging parameters (spectral Doppler) based on disease severity.
Methods: Patients referred for diagnostic carotid artery examination were invited to participate in the study. The results of the rapid examination were compared to the results of the traditional carotid duplex examination.
Results: Data from 250 patients (500 carotid arteries) were obtained. Patient age ranged from 23 to 92 years (median of 74 years). The traditional carotid examination was considered the gold standard and provided the following diagnoses for per carotid artery: normal (n=135, 27.0%), <50% stenosis (n=316, 63.2%), 50-59% stenosis (n=11, 2.2%), 60-69% stenosis (n=8, 1.6%), 70-79% stenosis (n=9, 1.8%), 80-89% stenosis (n=6, 1.2%), >90% stenosis (n=8, 1.6%), near occlusion (n=0, 0.0%), and occlusion (n=7, 1.4%). For the detection of 50-59% carotid artery stenosis, the rapid examination achieved sensitivity of 96.0% and specificity of 100.0%. For the detection of 60% carotid artery stenosis of any category, the rapid examination achieved 100% sensitivity and specificity. Time required to complete the rapid examination ranged from 21.2 seconds to 216.9 seconds.
Conclusion: The rapid examination is a novel screening test to exclude significant carotid artery stenosis, which can dramatically reduce examination time and cost without compromising diagnostic accuracy.
Biography
Ms Sarah Park |
Te Whatu Ora, Waikato
Sarah Park is a general and vascular specialist sonographer working at Waikato Hospital (Hamilton, New Zealand). Sarah is currently completing the Masters of Health Science (ultrasound) by research program at the University of Auckland. Her primary area of interest and research focus is the efficient and clinically targeted deployment of ultrasound across all ultrasound subspecialties, with a current emphasis on developing a rapid carotid duplex protocol. This protocol has the potential to significantly reduce examination time and enhance patient access to this examination.
