Extracranial Carotid Duplex Ultrasonography. Part II - Clinical Utility of Carotid Duplex Ultrasound

Carotid duplex ultrasonography (CDU) is noninvasive and easy to use for evaluation of various carotid artery diseases. Carotid atherosclerosis is a major indication for CDU. CDU can determine the degree of stenosis, plaque characteristics, and intima-media thickness for evaluation and estimation of carotid atherosclerosis, and can be used as a screening and follow-up tool after carotid revascularization. Here, we summarize the clinical indications and utility of CDU based on established evidence. The main topics include: 1) Evaluation and management of symptomatic and asymptomatic carotid atherosclerotic stenosis; 2) surveillance after carotid artery revascularization; 3) screening for cardiovascular risk; 4) perioperative evaluation; 5) evaluation of other diseases including cervical artery dissection, temporal arteritis, Takayasu's disease, and subclavian artery steal syndrome; and 6) diagnosis of dizziness, vertigo, and syncope. This special review will discuss rational indications and utility of CDU, and will be of interest to clinicians who provide care for patients with various extracranial carotid/vertebral artery diseases.