Technical advances in the field of ultrasound have resulted in the development of a high resolution real-time B-mode imaging system that permits direct Doppler analysis of hemodynamic abnormalities. This system combines both anatomic information and physiological information which permits detailed analysis of the entire spectrum of disease occurring at the carotid bifurcation. Future developments will permit improved management of patients at risk for stroke from carotid vascular disease.
Occlusion of the common carotid artery (CCA) has been reported to occur in as high as 3 to 20% of patients with symptomatic extracranial cerebrovascular disease, although a more recent report estimates this to be 2%.2 Successful extracranial cerebrovascular revascularization can be accomplished only if a patent internal carotid artery or external carotid artery is present.In patients with CCA occlusion, conventional angiographic techniques have been able to predict internal or external carotid artery patency in only 26% of patients found to have either patent at the time of surgical exploration.2 Therefore, exploration of the carotid bifurcation has been recommended in symptomatic patients despite angiographic nonvisualization of its branches.2,3 Other modalities are needed to document internal and/ or external carotid artery patency in patients with common carotid artery occlusion. Although
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