Carotid Ultrasound

1 What is a Carotid Ultrasound?

Carotid ultrasound is a safe, painless procedure that makes use of sound waves to examine the blood flow through the carotid arteries.

Your two carotid arteries are found on each side of your neck. They deliver blood from your heart to your brain.

Carotid ultrasound tests for any blocked or narrowed carotid arteries, which can increase the risks of stroke. The results can aid your doctor in determining a treatment to lower your risk of stroke.

2 Reasons for Procedure

Here are the most common reasons to undergo a carotid ultrasound procedure.

A carotid ultrasound is used to test for any narrowed arteries, which elevate the risk of stroke.

Carotid arteries are normally narrowed by a buildup of plaque, which is made up of fat, cholesterol, calcium and other substances that circulate in your bloodstream. An early diagnosis and treatment of a narrowed carotid artery can significantly reduce the risk of stroke.

Your doctor will make a recommendation of carotid ultrasound if you have a transient ischemic attacks (TIAs) or particular types of stroke or if you have any medical conditions that increase the risk of stroke, including:

  • High blood pressure
  • High cholesterol
  • Family history of heart disease
  • Diabetes
  • Coronary heart disease
  • An abnormal sound in carotid arteries (bruit), detected by your doctor using a stethoscope.
  • Recent transient attacks or stroke.

In order to screen for narrowed or blocked vessels in other areas of your body, you may need the following additional tests:

  • Abdominal ultrasound: You may have an abdominal ultrasound to tests for any condition that affects the blood vessels or organs in your abdominal area.
  • Ankle-brachial index test: This particular test measures and compares the blood pressure in your ankle and arm. The test shows reduced or blocked flow to your legs.
  • Cardiac stress test: This particular test shows how efficient your heart performs when under stress, such as during exercise. Results can indicate poor blood flow to the heart.
  • Imaging tests can also be ordered to detect coronary artery disease.

The other uses of Carotid Ultrasound

Your doctor may order a carotid ultrasound for the following reasons:

  • To evaluate blood flow through the artery after surgery to remove plaques (carotid endarterectomy).
  • To evaluate the placement and effectiveness of a stent, a mesh tube used to improve the flow of blood through an artery.
  • To locate a collection of clotted blood (hematoma) that may prevent blood flow.
  • To detect other carotid artery abnormalities that may disrupt blood flow.

3 Potential Risks

Carotid ultrasound has no potential risks because the test uses harmless sound waves.

They are the same type of sound waves that doctors use to record pictures of fetuses in pregnant women.

4 Preparing for your Procedure

You take these steps to prepare for your carotid ultrasound:

  • Call the day before the exam to confirm the time and place the exam will be held.
  • Wear a comfortable shirt with no collar or an open collar.
  • Do not wear a necklace or dangling earrings.

Unless your doctor or the radiology lab provides special instructions, you should not need to make any other preparations.

5 What to Expect

Here you can find out what to expect from your carotid ultrasound procedure.

How it operates

  • A technician, known as a sonographer, conducts the test with a small, hand-held device called a transducer.
  • The transducer emits sound waves and records the echo as wave’s bounce of tissue, organs and blood cells.
  • A computer translates the echoed sound waves into a live-action image on my monitor.

The radiologist may utilize a Doppler's ultrasound, which shows blood flowing through the arteries. In a Doppler ultrasound, the rate of blood flow is represented on a graph.

A carotid ultrasound typically takes about 30 minutes.

During the procedure

You will likely lie on your back during the ultrasound. The sonographer may position your head to get a better access to the sides of your neck. The sonographer will then apply warm gel to your skin above the side of each carotid artery. The gel helps in transmitting the ultrasound waves to and fro.

The sonographer will then gently press the transducer against the side of your neck. You should not feel any discomfort during the procedure. If you do, inform the sonographer.

6 Procedure Results

A doctor who has specialized in imaging tests (radiologist) will review the results of a carotid ultrasound. He or she will then prepare a report for the doctor who ordered the test.

This may be your primary care doctor, a doctor trained in heart and blood vessel conditions (cardiologist), or a doctor who has specialized in the nervous system conditions (neurologist).

The radiologist may also discuss the results of the test with you immediately after the procedure. The doctor who ordered the test will explain to you what the carotid ultrasound revealed and what that means for you.

If the test reveals you're at risk of a stroke, your doctor may recommend the following therapies, depending on the severity of blockage in your arteries:

  • Eat a healthy diet, including fruits, vegetables and whole-grain bread and cereals, and limit saturated fat.
  • Exercise regularly.
  • Keep a healthy weight.
  • Don't smoke and avoid secondhand smoke.
  • Take medications to lower blood cholesterol and blood pressure.
  • Take medications to prevent blood clots.
  • Have a surgical procedure to remove carotid artery plaques (carotid endarterectomy).
  • Have a surgical procedure to open up and support your carotid arteries (carotid angioplasty and stenting).

If your doctor ordered the carotid ultrasound as a follow-up to a surgical procedure, your doctor can explain whether the treatment is working and whether you'll need additional treatment or follow-up exams.

Additional tests

If your results are unclear, your doctor may order additional imaging tests, including:

  • Computerized tomography angiogram (CTA) scan: A CTA scan uses a series of X-rays to produce detailed images of the blood vessels in your body. Your doctor may inject a dye into a vein to highlight your carotid arteries.
  • Magnetic resonance imaging (MRI): An MRI uses a magnetic field and radio waves to produce detailed images of soft tissues in your body. A magnetic resonance angiography (MRA) scan also may be performed to get a better look at blood vessels.

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