Carotid artery injuries; Diagnostic imaging
Dear Editor,
We totally agree with the authors regarding the need to screen the entire extension of the carotid arteries (common, internal and external)11. Roelke LH, Rodrigues SL, Lotufo PA, Mill JG. Correlação da espessura médio-intimal das carótidas primitivas proximal e distal. Arq Bras Cardiol. 2013;101(3):211-6.. However, we would add the importance of screening them slowly and in the coronal plane, and of measuring the site where the intima-media thickness is visually greater. During the assessment, the coronal view of the vessel allows including the carotid lateral walls, adding accuracy to the examination22. Rosa EM, Kramer C, Castro I. Associação entre a doença aterosclerótica coronariana e a espessura médio-intimal da carótida comum através da ultrassonografia. Arq Bras Cardiol. 2003;80(6):589-92..
One of our colleagues, in his Master's degree thesis on Echography of the Carotid Arteries, concluded that strictly maintaining the measurement points elected by the American Society of Echocardiography (ASE) causes distortions regarding the maximum intima-media thickness, which can be obtained in each case22. Rosa EM, Kramer C, Castro I. Associação entre a doença aterosclerótica coronariana e a espessura médio-intimal da carótida comum através da ultrassonografia. Arq Bras Cardiol. 2003;80(6):589-92..
Referências
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1Roelke LH, Rodrigues SL, Lotufo PA, Mill JG. Correlação da espessura médio-intimal das carótidas primitivas proximal e distal. Arq Bras Cardiol. 2013;101(3):211-6.
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2Rosa EM, Kramer C, Castro I. Associação entre a doença aterosclerótica coronariana e a espessura médio-intimal da carótida comum através da ultrassonografia. Arq Bras Cardiol. 2003;80(6):589-92.
Reply
We thank your comments. It is important to consider that the software currently available is based on epidemiological research and measures only one small arterial segment. For clinical practice, it would be important to have other measuring methods that would assess a greater number of points along the carotid arteries. Three-dimensional ultrasound or another imaging method might be useful if a greater intimal mass to be measured could be determined. Intima-media thickness is a significant surrogate marker for atheromatosis, whose importance in guiding the clinical management of patients has increased. While such technologies are not fully available, we believe that measuring the carotid intima media thickness with longitudinal and coronal approaches, as suggested by our colleagues, would be currently ideal to better assess our patients.
Sincerely,
Leonard Hermann Roelke
Sergio Lamego
Rodrigues
Paulo Andrade Lotufo
Jose Geraldo
Mill
Publication Dates
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Publication in this collection
Apr 2014
History
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Received
25 Sept 2013 -
Reviewed
30 Oct 2013 -
Accepted
30 Oct 2013