Carotid Duplex Scan

Carotid Duplex Scans, also known as carotid artery ultrasound, are used to evaluate the carotid arteries which carry blood from the heart to the brain. These vital arteries are located on each side of the neck.  The ultrasound machine uses high-frequency sound waves to show the vessels.  A specialized Doppler technique is also used, allowing the visualization of movement of blood within the vessels. This provides detailed pictures that help your interventional radiologist determine the state of the carotid artery.  These images allow for detailed evaluation of the cause and extent of restricted blood flow due to carotid artery narrowing or blockage.

Your doctor may recommend a Carotid Duplex Scan if he suspects a possible abnormality involving your carotid artery.  Among the most common reasons are if you are at risk for stroke, have high blood pressure or if there is a structural abnormality with the vessel. A Transient Ischemic Attack (also called TIA or "mini-stroke") is one of the most important warning signs of a stroke. A TIA occurs when a blood clot briefly blocks an artery that supplies blood to the brain.  Plaque within the carotid artery, can sometimes serve as a source of these blockages, and is a treatable potential cause of stroke.

Symptoms of blockage, which may be early warning signs of a stroke, may include:

• Confusion
• Dizziness
• Drowsiness
• Headache
• Temporary blindness in one eye
• Temporary inability to speak or move

A Carotid Duplex Scan may also be used to identify carotid artery dissection, a condition whereby the layers of the carotid artery wall have split. This potentially compromises blood flow to certain areas of the brain and can lead to a stroke. Other instances such as fibromuscular dysplasia, which is a condition present from birth where the wall of the carotid artery is formed abnormally—and can also be an uncommon cause of stroke.

A Carotid Duplex Scan is often utilized in preparation for--or following--major heart surgery to see how well blood is flowing. Additionally, a Carotid Duplex Scan can find hematomas, or places where clotted blood has collected.  They are also used after carotid stenting—a procedure to open up narrowed carotid arteries without surgery, as well as carotid plaque removal surgery, also known as carotid endarterectomy.  This is to monitor the results of the procedure and to make sure there is no recurrence of narrowing.

During the Carotid Duplex Scan, you will lay face up on a movable exam table. Warm gel will be placed over either side of the neck and an ultrasound probe will gently be passed back and forth over the skin to image the carotid artery underneath.  The probe creates sound waves, which reflect off different structures in the area being scanned and are interpreted by the machine to create a precise image.  There is no risk from radiation with a Carotid Duplex Scan, and the probe usually causes no discomfort whatsoever.

The exam results will typically describe the carotid artery, any structural abnormality, the flow of blood, the presence of plaque and the degree of narrowing.  Not all plaque and narrowing requires surgical intervention and in many cases medical treatment will do an excellent job of reducing risk from carotid disease.  Your primary care doctor or interventional radiologist will discuss the findings and interpretation in more detail.

Why choose Fairfax Vascular Center?

While an ultrasound is a simple exam, there are many factors that go into successful imaging and interpretation.  These range from high-quality, updated ultrasound machines, experienced ultrasound technologists and experienced vascular and interventional radiologists.  These factors are particularly important when performing carotid artery duplexes to make sure any plaque or narrowing is accurately imaged.

At Fairfax Vascular Center we work very closely with neurointerventional specialists--physicians that treat stroke and carotid artery narrowing minimally invasively.  We also work very closely with vascular surgeons who perform surgery such as carotid endarterectomy to treat plaque.  Consequently, our interventional radiologists (dedicated vascular specialists) have some of the longest standing experience in imaging, assessing and interpreting carotid artery disease—for screening, stenting or post-surgical follow up.

Geographically, we are among the most experienced dedicated vascular specialists for diagnostic imaging related to the vascular system and vascular disease.  Thanks to our rigorous emphasis on quality of imaging and interpretation, we are able to provide our patients with the utmost in experience and care.

Have a discussion with your physician to determine if a carotid ultrasound is an appropriate part of your work up.