Carotid & Vertebral Ultrasound to Detect Atherosclerosis

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Swedish Vascular Ultrasound

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The carotid and vertebral arteries, which supply blood flow to the brain, are located on either side of the neck. These vessels can become narrowed due to atherosclerosis (hardening of the arteries) or plaques which develop inside artery walls. Atherosclerosis is a leading cause of heart attacks, stroke, and peripheral vascular disease. Plaques consist of necrotic cells, lipids and cholesterol crystals. Carotid artery atherosclerosis can increase the risk of a disabling or fatal stroke. When plaques become unstable, plaque particles can break off and migrate into smaller brain arteries, limiting blood flow. This is called an embolic stroke. 

A carotid/vertebral duplex test uses high frequency ultrasound to visualize blood vessel walls and examine bloodflow within the carotid, vertebral and subclavian arteries. Information regarding the degree and location of atherosclerosis and other abnormalities is obtained noninvasively. The information gathered by this exam is used to guide treatment decisions. Treatments used in the management of carotid atherosclerosis include medical therapy, carotid endarterectomy (CEA) and/or carotid artery stenting (CAS).

Carotid Duplex Exam

Ultrasound Image of Carotid Artery

Spectral Doppler waveform of carotid artery blood flow velocity 


Reasons for Test

• Symptoms of stroke or transient ischemic attack
• Monitor progression of existing disease
• Evaluate the results of carotid surgery and carotid stent placement
• Older patients with vascular risk factors of smoking, hypertension, diabetes & hyperlipidemia
• Carotid bruits

What to Expect

Prior to test: There is no preparation required for this test.

At the Testing Center

• You will be asked about your medical and surgical history
• You will have your blood pressure taken
• You may be allowed to have a family member or friend with you in the exam room during the test

During the Exam

• You will lie comfortably on a stretcher in the testing room; the lights will be dimmed
• A technologist will apply water soluble gel on your skin and gently move a transducer over each side of your neck to obtain images of your arteries and evaluate the blood flow.
• Doppler ultrasound amplifies the sound of the blood flow and you will hear a heartbeat like sound
• When the exam is done, the technologist will remove the gel from your skin using a soft washcloth and you will be ready to leave depending on the results.

After the Test

You are free to leave unless the technologist has critical findings to report to your doctor. You will be asked to wait at the facility for further instructions from your doctor after the results are shared. The technologist may need to take more images if requested by your physician.

How Long Will it Take?

40 – 60 minutes

Will it Hurt?

This exam is non-invasive and painless.


A specialized physician will analyze the images and send a report to your doctor. Your doctor will talk to you about the results and any further tests or treatments. After the test, call your doctor if you have worsening of your symptoms.