Cerebrovascular Disease

The association between extracranial arterial disease and cerebral vascular accidents (CVA) is well documented. Almost 50% of all cerebrovascular accidents are due to atherosclerotic extracranial disease and the vast majority of atherosclerotic lesions occur at the carotid bifurcation involving the bulb and proximal internal carotid artery. Fortunately, this area is readily accessible for a simple endarterectomy performed under local anaesthesia. Major vessel colour duplex ultrasound provides a rapid and accurate assessment of extracranial disease without the complications that may be associated with aortic arch angiography. Colour duplex ultrasound allows us to determine plaque morphology, i.e. which lesions are likely to be a source of embolic phenomena, and helps to differentiate plaque from intraluminal thrombus. If B-mode imaging indicates the presence of a significant lesion, PD samples blood flowing through the region and changes in velocity profiles indicate the degree of stenosis. Performed correctly, colour duplex ultrasound has almost eliminated the need for angiography prior to carotid endarterectomy and has proven to be more accurate than both MRI and CT angiography. Conversely, when conservative management is instituted, it is possible to monitor disease and its progression with minimal danger to the patient.

Indications:

• Amaurosis Fugax
• Carotid Bruits - symptomatic and asymptomatic
• Carotid Dissection
• Cerebral Vascular Accidents
• Dizziness
• Follow-up post Carotid Endarterectomy
• RIND
• Retinal Artery Emboli
• Serial Assessment of Carotid Artery Stenosis
• Subclavian Steal
• TIA
• Unexplained cerebral disorientation

Patient Preparation:

Nil preparation required.

Examination Duration:

30 minutes