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Carotid ultrasound is a low-cost, noninvasive, and accurate diagnostic imaging modality used to evaluate diseases of the carotid arteries. [2] It is most often used to diagnose carotid artery stenosis, a form of atherosclerosis , and has the capability to assess plaque morphology and characteristics. [ 1 ]
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.
Wada developed the technique of transient hemispheric anesthetization through carotid amytal injection to decrease the cognitive side effects associated with bilateral electroconvulsive therapy. [7] He published the initial description of motor, sensory, language, and effects on the "conscious state" in 1949, in Japanese .
This test has good sensitivity and specificity. [16] Typically duplex ultrasound scan is the only investigation required for decision making in carotid stenosis as it is widely available and rapidly performed. However, further imaging can be required if the stenosis is not near the bifurcation of the carotid artery.
To image the vessels of the neck such as common carotid, internal and external carotid arteries, AP, lateral, and 45 degrees bilateral oblique positions are taken. Contrast injection rate is 3 to 4 ml/sec with total volume of 7 to 9 ml. The frame rate of fluoroscopy is 3 to 4 frames/sec. [8]
The utility of the modified Allen's test is questionable, [4] and no direct correlation with reduced ischemic complications of radial artery cannulation have ever been proven. In 1983, Slogoff and colleagues reviewed 1,782 radial artery cannulations and found that 25% of them resulted in complete radial artery occlusion, without apparent ...
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Many carotid bruits are discovered incidentally in an otherwise asymptomatic patient. The presence of a carotid bruit alone does not necessarily indicate the presence of stenosis, and the physical examination cannot be used to estimate the degree of stenosis, if present; therefore, any bruit must be evaluated by ultrasound or imaging. [4]