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Carotid Artery Ultrasound

Last updated Feb. 5, 2019

Approved by: Maulik P. Purohit MD MPH

Nevit Dilmen

Image report of an R proximal Internal Artery Stenosis with Doppler flow.


Background Information:

What are the other Names for the Procedure?

  • Ultrasound Imaging - Carotid Artery

What is Carotid Artery Ultrasound Imaging Scan radiology procedure? (General Explanation)

  • Ultrasound imaging is a noninvasive procedure that uses high-frequency sound waves to produce real-time images. The procedure can be used to show movement of internal organs and blood flowing through blood vessels
  • A Carotid Artery Ultrasound procedure is used to image the carotid arteries, in order to assess any blockages that increase the risk of stroke. The procedure is also performed to assess the reason for a transient ischemic attack (TIA)
  • Doppler ultrasound is useful in assessing blood flow in arteries and veins in arms, legs, abdomen, and neck

What part of the Body does the Procedure involve?

The Carotid Artery Ultrasound Imaging procedure images the carotid arteries in the neck region.

Why is the Carotid Artery Ultrasound Imaging Scan radiology procedure Performed?

A Carotid Artery Ultrasound tool can be used for the following reasons:

  • To detect narrowing or blockages in carotid arteries, which increases the risk of stroke
  • To be performed in patients with high blood pressure, diabetes, high cholesterol, history of heart disease or stroke, carotid bruit, or in preparation of coronary endarterectomy procedure
  • To be used in biopsy for guidance, as it provides real-time images

Ultrasounds can also detect and assess:

  • Dissection of carotid artery: Dissection occurs as the layers of artery split (into 2 layers) and obstructs the blood flow
  • Condition of carotid artery after surgery (such as carotid endarterectomy)
  • Position of stent of carotid artery that keeps the carotid artery open for normal blood flow. In other words, to detect patency of carotid artery
  • Hematoma - blood clot that may stop the blood flow

Doppler ultrasound in children can be helpful to predict risk of stroke in sickle cell disease and find any blockages or abnormalities in blood and lymph vessels. It can also be useful to detect narrowing of vessels and tumors and other vascular abnormalities.

What is the Equipment used? (Description of Equipment)

The equipment for ultrasound imaging consists of:

  • An ultrasound transducer
  • A computer monitor
  • A central processing unit
  • A printer

A transducer is used to send high-frequency sound waves in the body and the computer creates the image based on the echoes of that sound returning from the patient’s body.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the ultrasound procedure.

What is the Cost of performing the Carotid Artery Ultrasound Imaging Scan radiology procedure?

The cost of a Carotid Artery Ultrasound procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Carotid Ultrasound Imaging procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently.

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=genus (accessed on 08/03/2014)

Prior to Carotid Artery Ultrasound Imaging Scan radiology procedure:

How does the Carotid Artery Ultrasound Imaging Scan radiology procedure work?

An Ultrasound Imaging - Carotid Artery procedure works in the following manner:

  • The ultrasound procedure works on similar principles used in sonar by submarines, to determine the size and shape of the object and how far away the object is
  • The transducer sends out high frequency sound waves in the body. When sound waves echo back from the body, the microphone in the transducer records the changes in the sound
  • And using the changes in the sound, it is possible to determine the shape, size, or any other changes in the structure of the organ
  • Using the change in the echoed sound, a computer produces a picture in real-time on the screen
  • Doppler ultrasound is used to determine the direction and speed of the blood cells

How is the Carotid Artery Ultrasound Imaging Scan radiology procedure Performed?

The Carotid Artery Ultrasound procedure is performed in the following manner:

  • The patient lies face-up on the table
  • A water-based gel is applied on the area of interest so that transducer can have better contact with the area and air pockets are eliminated between the transducer and body
  • A sonographer puts the transducer on the body and moves it around the area of interest to capture the desired image

Where is the Procedure Performed?

The Ultrasound Imaging - Carotid Artery procedure is performed either as an inpatient or outpatient procedure, at a hospital.

Who Performs the Procedure?

An Ultrasound Imaging - Carotid Artery procedure is usually performed by a radiology technologist.

How long will the Procedure take?

The Carotid Artery Ultrasound exam will take about 30 minutes.

Who interprets the Result?

  • A radiologist interprets the results of the Carotid Artery Ultrasound Imaging scan
  • A follow-up examination may be needed, if there is a suspicious abnormality that needs investigation/clarification

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to an Ultrasound Imaging - Carotid Artery procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • The ultrasound is not recommended, if the patient had had barium enema or GI tests in the past 2 days
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the scan
  • It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
  • The patient may be asked to avoid eating or drinking, several hours before the test

What is the Consent Process before the Procedure?

A physician will request your consent for a Carotid Artery Ultrasound Imaging procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of a Carotid Artery Ultrasound exam:

  • The ultrasound does not involve the use of any ionizing radiation
  • Ultrasound imaging is noninvasive, inexpensive, quick, and simple
  • The procedure captures clear images of soft tissues in real-time
  • The procedure can be used in needle biopsies or needle aspiration

Following are the risks of a Carotid Artery Ultrasound exam:

  • Generally none

What are the Limitations of the Carotid Artery Ultrasound Imaging Scan radiology procedure?

Following are the limitations of a Carotid Artery Ultrasound exam:

  • If there are any calcium deposits in the carotid artery, it may be difficult to evaluate the artery
  • Obtaining ultrasound images may be difficult, if the patient has a scar or wound on the neck, where the images are obtained from
  • Sometimes, contours on the neck or size of the neck make it difficult to obtain images
  • Soft plaque produces low-level of echo and thus, it cannot be detected using ultrasounds
  • It is not possible to obtain images of the entire blood vessel with ultrasound, as the last part of the carotid artery is under the bone. A CT or MRI scan may be required for these purposes
  • The quality of imaging depends upon the expertise of the technician taking the images

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is the Carotid Artery Ultrasound Imaging procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Carotid Artery Ultrasound Imaging Scan radiology procedure: 

What is to be expected during the Carotid Artery Ultrasound Imaging Scan radiology procedure?

  • The Carotid Artery Ultrasound procedure is completely painless, noninvasive, and there is no discomfort involved
  • The patient may be required to tilt their head to get the best images. The healthcare professional will help you during the procedure for optimum images

What kind of Anesthesia is given, during the Procedure?

No anesthesia is given during the Carotid Artery Ultrasound procedure.

How much Blood will you lose, during the Procedure?

There is no blood loss involved with the Carotid Artery Ultrasound procedure.

What are the possible Risks and Complications during the Carotid Artery Ultrasound Imaging Scan radiology procedure?

There are no known risks for a Carotid Artery Ultrasound Imagining scan.

What Post-Operative Care is needed at the Healthcare Facility after the Carotid Artery Ultrasound Imaging Scan radiology procedure?

There is no postoperative care necessary after a Carotid Artery Ultrasound Imaging scan.

After the Carotid Artery Ultrasound Imaging Scan radiology procedure:

What is to be expected after the Carotid Artery Ultrasound Imaging Scan radiology procedure?

  • Gel on both sides of the neck will be wiped-off, at the end of the Carotid Artery Ultrasound Imaging procedure
  • The patient may resume their normal activities soon after the procedure

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the gel; then, do contact the physician.

What Post-Operative Care is needed at Home after the Carotid Artery Ultrasound Imaging Scan radiology procedure?

There is no postoperative care necessary after a Carotid Artery Ultrasound exam.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time, after the Carotid Artery Ultrasound Imaging exam.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a Carotid Artery Ultrasound Imaging scan procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient. 

Who will you receive a Bill from, after the Carotid Artery Ultrasound Imaging Scan radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Radiologist or neurologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Carotid Artery Ultrasound Imaging procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 18, 2014
Last updated: Feb. 5, 2019