Ultrasound assessment of carotid arteries: Current concepts, methodologies, diagnostic criteria, and technological advancements

Abstract

Following cardiac disease and cancer, stroke continues to be the third leading cause of death and disability due to chronic disease in the developed world. Appropriate screening tools are integral to early detection and prevention of major cardiovascular events. In a carotid artery, the presence of increased intima-media thickness, plaque, or stenosis is associated with increased risk of a transient ischemic attack or a stroke. Carotid artery ultrasound remains a long-standing and reliable tool in the current armamentarium of diagnostic modalities used to assess vascular morbidity at an early stage. The procedure has, over the last two decades, undergone considerable upgrades in technology, approach, and utility. This review examines in detail the current state and usage of this integrally important means of extracranial cerebrovascular assessment.

Keywords: atherosclerosis; carotid stenosis; carotid ultrasound; color Doppler; duplex ultrasound; internal carotid artery stenosis; intima-medial thickness; plaque; sonography; stroke; three-dimensional ultrasound; transesophageal echocardiography; transpharyngeal examination; transpharyngeal ultrasound.