What is carotid artery screening?Screening exams find disease before symptoms begin. The goal of screening is to detect disease at its earliest and most treatable stage. In order to be widely accepted and recommended by medical practitioners, a screening program must meet a number of criteria, including reducing the number of deaths from the given disease. Show
Screening tests may include lab tests that check blood and other fluids, genetic tests that look for inherited genetic markers linked to disease, and imaging exams that produce pictures of the inside of the body. These tests are typically available to the general population. However, an individual's needs for a specific screening test are based on factors such as age, gender, and family history. In carotid artery screening, individuals who have no signs or symptoms of carotid artery disease undergo ultrasound (US) imaging of the carotid arteries, such as:
Ultrasound ImagingUltrasound imaging, also called ultrasound scanning or sonography or carotid duplex, is a safe and painless way to produce pictures of the inside of the body using sound waves. Conventional US involves the use of a small transducer (probe) to expose the body to high-frequency sound waves. Doppler ultrasound is a special ultrasound technique that evaluates blood flow — including both its speed and direction— through a blood vessel.
About Carotid Artery DiseaseThe carotid arteries are the two main arteries that carry oxygen-rich blood from the heart to the brain. These two blood vessels extend through each side of the neck. Carotid artery disease occurs when plaque (a build-up of fat, cholesterol and other substances) collects and forms along the walls of the carotid arteries. This buildup of plaque and the injury it causes is called atherosclerosis. Over time, the walls of affected arteries thicken and become stiff and the blood vessel may also become narrowed (a condition called stenosis), limiting blood flow. Left untreated, carotid artery disease increases the risk for stroke. A stroke occurs when blood flow to the brain is obstructed by plaque or blood clots, when bits of plaque break free and travel to smaller arteries in the brain, or when a blood vessel in the brain ruptures. A lack of oxygen and other essential nutrients may cause permanent damage to the brain or death. According to the Centers for Disease Control and Prevention (CDC), stroke is the fourth leading cause of death in the United States and a leading cause of long-term severe disability. Risk FactorsAnything that increases an individual's chances of developing disease is called a risk factor. Risk factors for carotid artery disease include:
top of page Who should consider carotid artery screening?Screening RecommendationsCarotid Duplex US
According to the Society for Vascular Medicine guidelines, carotid duplex US may be beneficial for assessing stroke risk in individuals who are 55 years of age or older with cardiovascular risk factors such as a history of:
The American Heart Association guidelines also state that carotid duplex US is a reasonable approach for asymptomatic patients with carotid bruit, an abnormal sound that may indicate turbulent blood flow, detected by a stethoscope when placed on top of the carotid arteries in the neck. Carotid intima media thickness (IMT) US According to the Society for Vascular Medicine and the American Society for Echocardiography (ASE), the use of carotid IMT US is most useful for refining the risk for cardiovascular disease in patients who are at intermediate risk for developing the disease. According to the ASE, the test may also be considered for individuals:
You should consult with your doctor to determine which screening tests for carotid artery disease are appropriate for you. top of page How is carotid artery screening performed?For most ultrasound exams, you will lie face-up on an exam table that can be tilted or moved. Patients may turn to either side to improve the quality of the images. The technologist applies a clear water-based gel to the body area under examination. This helps the transducer make secure contact with the body. It also helps eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The technologist or radiologist places the transducer on the skin in various locations, sweeping over the area of interest. They may also angle the sound beam from a different location to better see an area of concern. Doppler sonography and Carotid IMT US are performed using the same transducer. When the exam is complete, the technologist may ask you to dress and wait while they review the ultrasound images. top of page What are the benefits and risks of carotid screening?Carotid Ultrasound Benefits
Risks
top of page What happens if something is detected on my screening exam?If your carotid artery screening reveals that you have narrowing of the carotid arteries, hence are at risk of a stroke or other cardiovascular issue, your doctor may recommend one of the following therapies, depending on the severity of blockage in your arteries. Treatments for carotid artery disease may include medication to reduce cholesterol levels and high blood pressure, lifestyle changes (including healthy diet, exercise, and no smoking) and interventional procedures such as angioplasty and stenting or surgical procedures such as carotid endarterectomy to restore adequate blood flow to the brain. In angioplasty and vascular stenting, a balloon catheter is inserted to open the artery and a metal mesh tube called a stent is placed at the site of the blockage to keep the artery open. In carotid endarterectomy, plaque buildup is surgically removed. For more information, see the Angioplasty and Vascular Stenting procedure page. top of page Where can I find more information about carotid artery screening?You can find more information on carotid artery screening at:
top of page This page was reviewed on March, 18, 2020 ImagesView full size with caption Sponsored ByPlease noteRadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas. Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links. Which method would be most appropriate to assess the carotid arteries?Our doctors use noninvasive duplex ultrasound as the first and most important test to diagnose carotid artery disease. This exam provides information about the structure of the blood vessels as well as the blood flow within them.
What is the correct technique for Auscultating the carotid artery?Method Of Exam
Auscultate the carotid arteries with diaphragm and then with bell. It is important to listen to at least three locations over each carotid artery: 1) the base of neck; 2) the carotid bifurcation; and, 3) the angle of the jaw. Listen also over the subclavian artery.
How do you assess carotid artery quizlet?Palpate one artery at a time. - To palpate the carotid arteries, the nurse would lightly press on one side of the neck at a time. Never attempt to palpate both carotid arteries at the same time as bilateral palpation could result in reduced cerebral blood. It is not necessary to count the carotid rate.
Which technique would be most appropriate to use when examining the jugular venous pulse?It has been taught that the best method for evaluating the JVP is to position the patient supine in bed, elevate the patient's head to approximately 30–45 degrees, and measure or estimate the vertical height of the meniscus of the right internal or external jugular vein above the sternal angle (angle of Louis) which is ...
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