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Thanks for the question, Brian,
There are numerous carotid stenosis grading criteria published out there that can be used within ultrasound departments, which is likely what you have stumbled across. We recommend referring back to the local guidelines and vascular surgeon for criteria preference (which it seems you are already doing so).
In light of that, what we have noticed is that the main discrepancy tends to occur at the lower end of the scale (50-69% stenosis)
The ASUM guidelines are a great reference. In the presence of disease, you have to have a PSV of >125cm/s AND a ratio of >2 OR just a ratio >2 for a 50-69% stenosis. Again, these are just guidelines and not a criteria.
Hope this covers your question.
Kind Regards,
Heath/Vascular SIG