Carotid and cerebrovascular sonography uses duplex ultrasound to evaluate the extracranial carotid and vertebral arteries for atherosclerotic plaque, stenosis, and occlusion. It is a primary tool for stroke risk stratification and management of patients with transient ischemic attacks (TIA) and prior strokes.
Sonographers measure intima-media thickness (IMT), characterize plaque morphology (echogenicity, surface, calcification), and quantify the degree of internal carotid artery stenosis using peak systolic velocity criteria. Vertebral artery patency and flow direction (to exclude subclavian steal) are routinely assessed. Surveillance of carotid stents and endarterectomy sites is also performed.
Carotid sonography is the core application of the ARDMS Vascular Technology (VT) specialty within the RVT credential. Carotid labs are found in neurology departments, stroke centers, vascular surgery practices, and hospital radiology departments. Accurate stenosis grading directly influences surgical and endovascular treatment decisions.