Carotid Ultrasound

Overview of Carotid Ultrasound

Carotid ultrasound (also referred to as Doppler ultrasound or Carotid duplex ultrasound) is a pain-free and harmless test that employs high-frequency sound waves to create photos of the insides of the two large arteries in the neck. These arteries, called carotid arteries, provide the brain with oxygen-rich blood. 

Carotid ultrasound depicts whether a substance called plaque has narrowed carotid arteries. Plaque is formed of fat, cholesterol, calcium, and other substances present in the blood. Plaque builds up on the insides portion of arteries as we age. This condition is called Carotid Artery Disease.

A carotid ultrasound can depict whether plaque buildup has narrowed one or both of the carotid arteries and decreased flow of blood to the brain. If plaque has narrowed an individual's carotid arteries, they may be at risk of having a stroke. To decrease the risk of stroke, healthcare professionals may advise medical or surgical treatments to lessen or remove the plaque buildup in carotid arteries.

When Would a Carotid Ultrasound be Required?

A carotid artery ultrasound may be necessary when a healthcare provider seeks to examine for the presence of blood clots or plaque buildup, consisting of fat and cholesterol deposits, along the walls of the carotid arteries. Such deposits have the potential to restrict, and ultimately obstruct, the flow of blood to the brain, face, and neck, potentially leading to a stroke.

One may require a carotid ultrasound if:

• Had surgery on a narrowed artery.
• Require a follow-up on a stent in the carotid artery.
• Are getting periodic checks because the artery was narrow during a previous checkup.
• Have a bruit (rare sound like a whoosh) healthcare provider could hear through a stethoscope against the artery.
• Have elevated blood pressure or cholesterol levels.
• Had a stroke.
• Had transient ischemic attack (TIA).
• Going to have coronary artery bypass surgery.
• Suffering from diabetes.
• Have a family history of stroke or cardiac ailment.
• Suffering from a hematoma (collection or pool of blood)

Who Performs Carotid Ultrasound?

A healthcare provider known as a sonographer or ultrasound technologist conducts ultrasound tests, but a radiologist can also perform them.

How does a Carotid Artery Ultrasound Work?

A carotid ultrasound doesn't involve radiation; instead, it makes use of sound waves to generate images of the interior of carotid arteries. A computer processes data from the transducer, the device placed on an individual's skin by the healthcare provider, to produce carotid ultrasound images displayed on a monitor. The sonographer can capture videos of the scans or save snapshots, similar to photos.

How to Prepare

One can take the following steps to prepare for appointment:

• Call the day prior to the exam to confirm the time and exam location.
• Wear a comfortable shirt without a collar or an open collar.
• Don't wear jewelry.

During the Procedure

• Individuals can likely lie on their back during the ultrasound. The ultrasound technician may position the Individual's head to better access the side of the neck.
• The ultrasound technician will apply a warm gel to the skin overlying each carotid artery. This gel assists in transmitting the ultrasound waves effectively. Subsequently, the technician gently places the transducer against the side of the neck.
• The individual shouldn't feel any discomfort during the procedure. If they do so, they can tell the ultrasound technician.

Results and Follow-Up

What type of results do healthcare providers get, and what do the results mean?

Healthcare providers will receive a result indicating the degree of blockage in the arteries, expressed as a percentage out of 100.

Average results indicate carotid arteries aren't narrowed or blocked.

If results aren't typical, an individual may have atherosclerosis, a blood clot, or some other problem that makes the artery too narrow and puts the Individual at risk for a stroke.

If an individual shows plaque accumulation in one or both carotid arteries, yet the blockage is below 50% (with stroke or TIA symptoms) or 60% (without stroke or TIA symptoms), a healthcare provider might advise dietary improvements, increased physical activity, and cessation of tobacco usage.

Also, healthcare providers may prescribe medication to:

• Dissolve blood clots (thrombolytics).
• Prevent blood clots (aspirin or clopidogrel).
• Lower cholesterol level (statins).
• Bring down blood pressure (antihypertensives).

For instance, in cases where the buildup is more critical (at least 50% with stroke or TIA manifestations, or 60% without stroke or TIA manifestations), healthcare providers may recommend a carotid endarterectomy to eliminate the plaque. The results of the carotid artery ultrasound can guide them in planning this procedure by indicating the location of the blockage. An alternative treatment for severe blockage, angioplasty, involves pushing plaque deposits against artery walls to widen the passage for blood flow. A stent can then be used to keep the artery open after angioplasty.

A carotid ultrasound is generally precise, but there can be occasions when it looks like a blockage, but there isn't one. Healthcare providers may want individuals to have more imaging tests, like cerebral, CT, or magnetic resonance angiography. Individuals may require these other types of imaging because of bone that blocks the ultrasound's view of part of the carotid artery. The ultrasound can't see through the bone.

In a nutshell, carotid ultrasound is a vital diagnostic tool for examining the health of the carotid arteries and detecting potential issues like plaque buildup that could lead to blockages and increase the risk of stroke. It's a non-invasive, painless procedure that utilizes sound waves to create images of the arteries' interiors. By recognizing blockages and assessing their severity, healthcare providers can determine appropriate treatment plans to alleviate the chances of stroke, ranging from lifestyle alterations to medical interventions or surgical procedures. Regular monitoring through carotid ultrasound is crucial for individuals with risk factors or a history of vascular-related conditions, enabling timely intervention as well as management.