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Carotid artery stenosis is a major risk factor for stroke, and risk assessment of atherosclerotic carotid plaques is a critical component of stroke prevention. Advances in imaging have allowed for risk stratification including degree of stenosis and how vulnerable the atherosclerotic plaque is to rupture.
The internal carotid artery supplies the brain, and the external carotid artery supplies the face. This fork is a common site for atherosclerosis, an inflammatory build-up of atheromatous plaque inside the common carotid artery, or the internal carotid arteries that causes them to narrow. [3] [4]
Carotid duplex: A carotid duplex is an ultrasound study that assesses whether or not you have atherosclerosis (narrowing) of the carotid arteries. These arteries are ...
The carotid artery is the usual site of measurement of IMT and consensus statements for carotid IMT have been published for adults [12] and children. [13] Often, carotid IMT is measured in three locations: in the common carotid artery (typically at one cm proximal to the flow divider), at the bifurcation, and in the internal carotid artery.
Ultrasonic duplex scanning was developed to primarily determine the extent of atherosclerosis in carotid arteries. [3] Since then, its application has widened to include arteries in the limbs. The technique utilizes high-frequency sound waves for visualization of flow direction and velocity within the arteries in an area of interest.
Duplex is an inexpensive, non-invasive way to determine pathology. It is used in for example: Carotid ultrasonography; Ultrasonography of deep venous thrombosis; Ultrasonography of chronic venous insufficiency of the legs; Duplex evaluation is usually done prior to any invasive testing or surgical procedure. [8]
Symptoms of carotid artery stenosis can include transient ischemic attack or stroke. Both symptomatic and asymptomatic carotid stenosis can be diagnosed with the aid of carotid duplex ultrasound which allows for the estimation of severity of narrowing as well as characterize the plaque.
Incidental thyroid masses may be found in 9% of patients undergoing bilateral carotid duplex ultrasonography. [12] Some experts [13] recommend that nodules > 1 cm (unless the TSH is suppressed) or those with ultrasonographic features of malignancy should be biopsied by fine needle aspiration.