Selection of patients for carotid endarterectomy: The role of ultrasound

Fabrizio Calliada, Lucia Verga, Simona Pozza, Olivia Bottinelli, Rodolfo Campani

Research output: Contribution to journalArticlepeer-review


Stroke is the third leading cause of death in the western world and the major cause of disability among the middle aged and elderly populations. Carotid artery stenosis is the single most important risk factor for stroke. The North American Symptomatic Carotid Endarterectomy Trial and the European Carotid Surgery Trial have demonstrated that the risk of stroke is reduced by surgery in patients with high grade stenosis. Carotid plaque morphology also plays an important role; plaques which are ulcerated and echolucent are associated with a higher risk of stroke. Arteriography has long been regarded as the gold standard diagnostic tool for evaluation of carotid artery disease, but it is an invasive and costly technique which carries the risk of potentially serious complications. Doppler ultrasound can provide functional and anatomical information on vessel stenosis and plaque morphology at sub- millimetric resolutions and is an inexpensive and noninvasive tool. Color and spectral Doppler ultrasound are now recognized as the best screening tests for carotid artery stenosis. The evidence for its use as the sole diagnostic imaging modality prior to carotid endarterectomy is examined. The recent availability of ultrasound contrast agents helps to distinguish between pseudo- and true occlusions, improves ultrasound images and should help to reduce operator variability.

Original languageEnglish
JournalJournal of Computer Assisted Tomography
Issue numberSUPPL.
Publication statusPublished - Nov 1999


  • Arterial occlusive diseases
  • Carotid arteries
  • Carotid endarterectomy
  • Carotid stenosis
  • Cerebral ischemia
  • Contrast media
  • Radiography
  • Ultrasonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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