Carotid artery disease

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Tests and diagnosis

By Mayo Clinic staff

In addition to taking a thorough medical history and recording risk factors and any signs or symptoms, your doctor may conduct or request several tests to evaluate the health of your carotid arteries:

  • Physical examination. Your doctor may hear a "swooshing" sound (bruit) over the carotid artery in your neck, a sound that's characteristic of a narrowed artery. Or your doctor may observe cholesterol fragments (emboli) in the tiny blood vessels of your retina, at the back of your eye, during an eye examination. A test that compares the arterial blood pressure in each eye with the blood pressure in each arm also may be done.
  • Ultrasound. A common, noninvasive test used to check for carotid artery disease is a Doppler ultrasound. This variation of the conventional ultrasound assesses blood flow and pressure — and possible narrowing of the blood vessel — by bouncing high-frequency sound waves (ultrasound) off red blood cells.
  • Computerized tomography angiography (CTA). This imaging test uses a contrast dye to highlight your carotid arteries in the pictures taken. The dye is injected into a blood vessel. When it travels to your carotid arteries, a computerized tomography (CT) scan gathers X-ray images of your neck and brain from many angles.
  • Magnetic resonance angiography (MRA). Like CTA, this imaging test uses a contrast dye to highlight the arteries in your neck and brain. A magnetic field and radio waves are used to create cross-sectional, 3-D images.
  • Cerebral angiogram. A more traditional, and more invasive, imaging procedure called a cerebral angiogram may sometimes be done, but its use is less common, as it carries a slight risk of stroke. In this procedure, contrast dye is injected with a catheter that's been threaded directly into your carotid arteries. Detailed X-ray images are then taken.
Treatments and drugs Preparing for your appointment
References
  1. Lee JT, et al. Peripheral arterial disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/151488178-7/866918859/1621/197.html#4-u1.0-B978-1-4160-4435-2..50101-1_1467. Accessed July 23, 2009.
  2. Riles TS, et al. Cerebrovascular disease. In: Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/151488178-3/866914256/1565/622.html#4-u1.0-B978-1-4160-3675-3..50068-X--cesec4_3762. Accessed July 23, 2009.
  3. Schwartz JB, et al. Vascular disease. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007.http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..50078-9--cesec28&uniq=151488178&isbn=978-1-4160-4106-1&sid=866915121#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-4106-1..50078-9--cesec95%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-1-4160-4106-1. Accessed July 23, 2009.
  4. Carotid artery disease. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/catd/catd_whatis.html. Accessed July 23, 2009.
  5. Carotid artery disease, stroke, transient ischemic attacks (TIAs). Society for Vascular Surgery. http://www.vascularweb.org/patients/NorthPoint/Carotid_Artery_Disease.html. Accessed July 23, 2009.
  6. Furie KL, et al. Secondary prevention of stroke: Risk factor reduction. http://www.uptodate.com/home/index.html. Accessed July 23, 2009.
  7. Angioplasty and vascular stenting. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?pg=angioplasty. Accessed Aug. 28, 2009.
  8. Questions and answers about carotid endarterectomy. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/stroke/carotid_endarterectomy_backgrounder.htm. Accessed Aug. 12, 2009.
  9. Greelish JP, et al. Carotid angioplasty and stenting. http://www.uptodate.com/home/index.html. Accessed July 23, 2009.
  10. Greelish JP, et al. Carotid endarterectomy: Preoperative evaluation; surgical technique; and complications. http://www.uptodate.com/home/index.html. Accessed July 23, 2009.
  11. Sodium. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4708. Accessed July 23, 2009.
  12. Stop smoking: Resources and tools for quitting. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3038010. Accessed July 23, 2009.
  13. Rundek T, et al. Risk factor management to prevent first stroke. Neurologic Clinics.2008;26:1007.

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Oct. 1, 2009

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