Indications for Ultrasound of the Neck Arteries

Abstract

Ultrasound of the neck arteries is a reliable, noninvasive and safe investigation. It enables the evaluation of atherosclerosis in the primary prevention of vascular diseases and has an even more important role in the secondary prevention of ischemic stroke. A quarter of ischemic infarctions can be explained by hemodynamically important carotid stenosis and subsequent thrombembolism. Patients with a hemodynamically important carotid stenosis have a bad prognosis which changes dramatically if they receive surgical, endovascular or even intensive drug treatment. Due to time and human resource limitations we can not perform ultrasound of the neck arteries in the entire population. Patients who need urgent investigation are lost in the crowd of other not so urgent patients, and therefore we wrote the present guidelines. Carotid ultrasound is an urgent investigation for most symptomatic patients – ABCD score enables evaluation of emergency. In the group of asymptomatic patients screening of particular endangered groups of patients is recommended. The evaluation of emergency should be rational and also based on age and clinical data of the patient. A referring physician should follow the present guidelines and make decision about the urgency of the investigation.