AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System, 2026 Revision

IndicationsIndications for an ultrasound examination of the extracranial carotid, vertebral arteries, or jugular veins include, but are not limited to:1. Evaluation of patients with hemispheric neurologic symptoms, including stroke, transient ischemic attack, and amaurosis fugax.1-3 2. Evaluation of patients with a cervical bruit.3. Evaluation of pulsatile neck masses.4. Preoperative evaluation of patients scheduled for major cardiovascular surgical procedures. 5. Evaluation of nonhemispheric or unexplained neurologic symptoms.6. Follow-up evaluation of patients with known or documented carotid disease.7. Postoperative or postintervention evaluation of patients following cerebrovascular revascularization, including carotid endarterectomy, stenting, or carotid-to-subclavian artery bypass graft.8. Intima-media thickness measurement for cardiovascular risk stratification 9. Intraoperative monitoring of vascular surgery.10.Evaluation for suspected subclavian steal syndrome.4 11.Evaluation for suspected carotid artery dissection, 5 arteriovenous fistula, or pseudoaneurysm.12. Evaluation of patients with carotid reconstruction after extracorporeal membrane oxygenation (ECMO) bypass.13.Evaluation of patients with syncope, seizures, or dizziness.14.Screening high-risk patients including atherosclerosis elsewhere, history of head and neck radiation, known fibromuscular dysplasia (FMD), Takayasu arteritis, or other vasculopathy in another circulation.15.Neck trauma.16.Hollenhorst plaque visualized on retinal examination.17.Screening of patients at high risk for atherosclerotic cardiovascular disease of the carotid artery.18. Evaluation for suspected jugular vein, brachiocephalic vein, or superior vein compression or thrombosis.