Evaluation of intracranial tandem lesions in patients with carotid artery disease

Tanja Rundek, Arijana Huzjan Lovrenčić, Dražen Runjić, Vida Demarin

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Background and purpose: Patients with occlusive extracranial carotid disease may have an intracranial occlusive disease, what is called tandem lesion (TL). In order to estimate the incidence of TL, patients with cerebrovascular disease were investigated by Transcranial Doppler sonography (TCD) and Carotid Color Doppler Flow Imaging (CCDFI). Material and methods: We analyzed in data on 311 consecutive patients with carotid artery stenosis. CCDFI was performed by Acuson 128-XP with 7.5 MHz probe. Patients were classified into five groups according to the severity of carotid artery stenosis: group I - mild (30-50%), group II - moderate (51-70%), group III - severe stenosis (71-99%), group IV - occlusion of one carotid artery, and group V - combination of bilateral severe stenosis or severe stenosis of one carotid artery and contralateral carotid occlusion or occlusion of both carotid arteries. Transcranial Doppler was measured by TCD EME 3D scanner with 2 MHz probe. Tandem lesions were categorized according to the properties of blood flow velocities as very possible, possible or probable TL. Results: In the group I (81 patients) 18 patients (22%) had very possible TL. In the group II (59 patients) 5 (8%) had very possible TL, and 10 (17%) possible TL. In the group III (81 patients) 18 (22%) had very possible TL, and 16 (20%) had probable TL. In the group IV (70 patients) 24 (34%) had very possible TL and 16 (23%) had probable TL. In the group V (20 patients) 5 (23%) had very possible TL and 4 (20%) had probable TL. Conclusions: Tandem lesions, with the most certainty, were frequently found in patients with advanced extracranial carotid artery disease. Although the clinical relevance of this finding is still a matter of controversy, our results stress the importance of TCD evaluation in patients with carotid disease which implicates a different therapeutical approach.

Original languageEnglish (US)
Pages (from-to)89-94
Number of pages6
JournalPeriodicum Biologorum
Issue number1
StatePublished - Mar 1 1996
Externally publishedYes


  • Carotid Color Doppler
  • Carotid disease
  • Tandem lesions
  • TCD

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)


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