Significant Carotid Artery Stenosis: Definition and How to Provide A Clinically Useful Report

Abstract:
Cerebrovascular disease is a significant cause of mortality and morbidity. Most strokes are ischemic and most ischemic strokes occur secondary to emboli, of which 15%are likely originate from vulnerable plaque at carotid bifurcation.
Doppler ultrasound has emerged as the primary noninvasive imaging modality for detecting, grading and monitoring internal carotid stenosis, due to its high sensitivity and specificity, low cost, lack of ionizing radiation and avoiding of iodinated or gadolinium containing contrast. At present a number of different criteria are used to grade carotid stenosis. Awareness of limitations of carotid stenosis grading criteria and confounding factors of stenosis measurement are important for providing reliable final report. Other imaging modalities maybe advised in case of no conclusive Doppler study.