Carotid Artery Duplex Scan (Carotid Ultrasound)

Ultrasonography is a noninvasive method of diagnostic testing in which ultrasound waves are sent into the body with a small transducer pressed against the skin.

Test Description

Ultrasonography is a noninvasive method of diagnostic testing in which ultrasound waves are sent into the body with a small transducer pressed against the skin. The transducer then receives any returning sound waves, which are deflected back as they bounce off various structures. The transducer converts the returning sound< waves into electric signals that are then transformed by a computer into audible sounds (Doppler method) which can be graphed. A visual image of the carotid artery< can be seen on the monitor, as well as in a printed copy of the image.
 
Carotid Ultrasound

In this particular type of ultrasonography, the blood flow through the carotid arteries is studied. The movement of blood cells causes a change in pitch of the reflected sound waves, a phenomenon known as the Doppler effect. The sound pitch does not change if there is no blood flow through the artery. This provides a noninvasive method of assessing bruits during systole and diastole. Sounds emitted< during the examination change when turbulent blood flow caused by plaque, stenosis, or partial occlusion of the artery is encountered. Such testing is often used in the evaluation of patients diagnosed with syncope, transient ischemic attack (TIA), and stroke.
You want to read: Carcinoembryonic Antigen (CEA)
There are two types of Doppler ultrasound typically used for evaluating the carotid artery. Duplex Doppler ultrasound uses standard ultrasound methods to produce pictures of the blood vessel and surrounding organizations. Color Doppler ultrasound provides the same information as the Duplex Doppler but with the addition of colors to the blood vessel to represent the speed and direction of blood flow through the vessel.

THE EVIDENCE FOR PRACTICE

Carotid endarterectomy (CE) is established as effective for recently symptomatic (within previous 6 months) patients with 70% to 99% internal carotid artery (ICA) angiographic stenosis.

Normal Values

Normal carotid artery blood flow

Possible Meanings of Abnormal Values

  • Aneurysm
  • Carotid artery occlusive disease

Contributing Factors to Abnormal Values

  • The transducer must be in good contact with the skin as it is being moved.
  • Use of nicotine in any form within 2 hours of the test will cause vasoconstriction and possibly false results.

Interventions/Implications

Pretest

  • Explain to the patient the purpose of the test. Provide any written teaching materials available on the subject. Note that there is no discomfort involved with this test.
  • No fasting is required before the test

Procedure

  • The patient is assisted to a supine position on the ultrasonography table, with the head turned slightly to one side.
  • The patient must remain very still during the exam.
  • A coupling agent, such as a water-based gel, is applied to the area to be evaluated.
  • A transducer is placed on the skin and moved as needed to provide clearly emitted sounds.
  • The sound waves are transformed into audible sounds which are then printed in graphic form.

Posttest

  • Cleanse the patient’s skin of remaining coupling agent.
  • Report abnormal findings to the primary care provider.

Clinical Alerts

Unless contraindicated, aspirin therapy should be considered for symptomatic and asymptomatic patients undergoing CE prior to surgery and for at least 3 months following surgery to reduce the combined endpoint of stroke, myocardial infarction, and death.

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Dr Lobby | DrLobby.com: Carotid Artery Duplex Scan (Carotid Ultrasound)
Carotid Artery Duplex Scan (Carotid Ultrasound)
Ultrasonography is a noninvasive method of diagnostic testing in which ultrasound waves are sent into the body with a small transducer pressed against the skin.
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