Ultrasound of the carotid arteries: a pictorial review

Stroke secondary to atherosclerotic disease remains one of the leading causes of death. Ischemia from severe, flow limiting stenosis due to atherosclerotic disease involving the extracranial carotid arteries is implicated in approximately 20-30% of strokes. An estimated 80% of strokes are thromboembolic in origin, often with carotid plaque as the embolic source, usually involving the internal carotid artery within 2 cm of the carotid bifurcation. Carotid endarterectomy has been proven to be more beneficial than medical therapy in symptomatic patients with greater than 70% stenosis. Accurate diagnosis of hemodynamically significant stenosis is therefore critical in identifying those patients who would benefit from the surgery. In this paper we present a pictorial review of the use of ultrasound in the examination of the carotid arteries.