Abstract
INTRODUCTION: Distal extracranial internal carotid artery (ICA) follow-up after stenting could be challenging because of tortuosity and anatomic limitations, requiring second-line invasive exams such as CT angiography (CTA) and digital subtraction angiography (DSA). The aim of our study was to validate a new diagnostic ultrasound (US) modality, using a transcranial probe (TP), for the evaluation of the distal cervical ICA segment after endovascular stenting. METHODS: From January 2022 to February 2024, all patients stented for high extracranial carotid disease in an acute or elective setting were retrospectively enrolled. A three-month US follow-up was conducted with linear and transcranial probes. CTA and DSA were used as a standard of reference. RESULTS: A total of 46 patients in whom high ICA stenting was performed were included. Emergency carotid stenting was performed in 69.5%. For the evaluation of stent patency, TP demonstrated a sensitivity and specificity of 100% and 97.4%, respectively. For intrastent stenosis/decoupling in overlapping stents or pseudoaneurysm exclusion, TP demonstrated a sensitivity and specificity of 66.7% and 97.4%, respectively. CONCLUSION: US evaluation using a TP with submandibular approach could be a novel, non-invasive method for stenting follow-up in distal extracranial ICA.