Ultrasound Scan:
Carotid Arteries Doppler

Carotid artery disease refers to the narrowing or blockage of the carotid arteries, which are the major blood vessels located on each side of the neck. These arteries supply oxygen-rich blood to the brain. Carotid artery disease is primarily caused by atherosclerosis, which is the buildup of fatty deposits, cholesterol, calcium, and other substances within the artery walls, forming plaques.

 

Over time, these plaques can grow and restrict the flow of blood through the carotid arteries. They can also become unstable and rupture, leading to the formation of blood clots. If a clot completely blocks the artery or travels to smaller blood vessels in the brain, it can result in a stroke or transient ischemic attack (TIA), also known as a mini-stroke.

 

Carotid artery disease often develops slowly and may not cause symptoms until a significant blockage or clot formation occurs. Symptoms, when they do occur, can vary depending on the degree of artery narrowing or blockage and whether blood flow to the brain is compromised.

 

Diagnosing carotid artery disease typically involves a combination of medical history assessment, physical examination, and imaging tests. Carotid Doppler ultrasound scans are commonly used to evaluate the degree of artery narrowing and blood flow patterns.

This scan usually takes between 15-20 minutes to complete.

​

A Carotid Doppler study looks at the arteries in your neck to assess the blood flow to your brain. This ultrasound requires direct contact with your skin. We will require you to remove any jackets and possibly jumpers as well. We also recommend you remove any necklaces to avoid getting gel on them.

We will ask you to lie on your back on our examination bed. During the scan we will apply gel to your neck and use the ultrasound machine to look at the arteries. You may or may not hear noises from the ultrasound machine; this is all normal and of no concern.

Carotid Doppler ultrasound scans are non-invasive, painless, and provide real-time imaging of the carotid arteries. Carotid Doppler ultrasound scans, also known as carotid artery ultrasound or carotid duplex ultrasound, are performed to assess the blood flow and detect any abnormalities in the carotid arteries, which are the major arteries in the neck that supply blood to the brain. The most common type of narrowing or occlusion is caused by either atherosclerosis (plaque) or thrombus (blood clot). A carotid Doppler ultrasound scan may be requested for a number of reasons such as:

 

Evaluating Carotid Artery Disease

Carotid Doppler ultrasounds are commonly performed to assess the presence and severity of carotid artery disease. This condition involves the buildup of plaque (atherosclerosis) within the carotid arteries, which can lead to narrowing (stenosis) or complete blockage of the arteries. Ultrasound can detect the presence of plaque and determine the degree of stenosis aiding in the diagnosis and management of carotid artery disease.

​

Assessing Stroke Risk

Carotid artery disease is a significant risk factor for stroke. By evaluating the carotid arteries, Doppler ultrasounds can help identify individuals at an increased risk of stroke due to plaque buildup or narrowing in the carotid arteries. This information assists healthcare providers in determining appropriate preventive measures, such as medication, lifestyle modifications, or further interventions to reduce the risk of stroke.

​

Monitoring Disease Progression

For individuals diagnosed with carotid artery disease, routine carotid Doppler ultrasounds can be performed to monitor the progression of the disease over time. This helps healthcare providers assess the effectiveness of treatments and interventions and make necessary adjustments to manage the condition effectively.

 

Preoperative Assessment

Carotid Doppler ultrasounds are often conducted prior to certain surgical procedures, such as carotid endarterectomy or carotid artery stenting. These ultrasounds provide detailed information about the carotid artery anatomy, the extent of stenosis, and the location of plaque, helping surgeons plan the procedure and ensure patient safety.

 

Investigating Symptoms: Carotid Doppler ultrasounds may be ordered when individuals experience symptoms such as transient ischemic attacks (TIAs) or mini-strokes, dizziness, blurred vision, or other signs that may suggest carotid artery disease or compromised blood flow to the brain. Ultrasound can help identify potential causes of these symptoms and guide further evaluation and treatment.

Age

The risk of developing carotid artery disease increases with age, especially in individuals over 55 years old.

 

Gender

Men have a higher risk of carotid artery disease compared to premenopausal women. However, after menopause, the risk becomes similar between men and women.

 

Family history

Having a family history of carotid artery disease or stroke increases the risk of developing the condition. This suggests a genetic predisposition to the disease.

 

Smoking

Tobacco smoking, including both active smoking and exposure to secondhand smoke, significantly increases the risk of carotid artery disease. Smoking damages blood vessels and accelerates the development of atherosclerosis.

 

High Blood Pressure

Hypertension, or high blood pressure, is a major risk factor for carotid artery disease. High blood pressure can damage the arterial walls, making them more susceptible to plaque formation and narrowing.

​

High Blood Cholesterol

Elevated levels of LDL cholesterol (often referred to as "bad" cholesterol) and reduced levels of HDL cholesterol (often referred to as "good" cholesterol) are associated with an increased risk of carotid artery disease. High cholesterol contributes to the formation of plaque within the arteries.

 

Diabetes

Individuals with diabetes are at a higher risk of developing carotid artery disease. Diabetes affects the body's ability to regulate blood sugar levels and can damage blood vessels, accelerating atherosclerosis.

 

Obesity

Excess body weight, especially abdominal obesity, increases the risk of carotid artery disease. Obesity is often associated with other risk factors such as high blood pressure, high cholesterol, and diabetes.

 

Sedentary lifestyle

Lack of regular physical activity and a sedentary lifestyle contribute to the development of carotid artery disease. Regular exercise promotes cardiovascular health and helps control other risk factors such as high blood pressure and cholesterol levels.

 

Poor Diet

Diets high in saturated fats, trans fats, cholesterol, and sodium contribute to the development of carotid artery disease. A diet lacking fruits, vegetables, and whole grains further increases the risk.

 

Injury to the Carotid Arteries

Injury to the carotid arteries such may result in complications such as dissection.

 

Other Medical Conditions

Certain medical conditions, such as kidney disease, autoimmune disorders, and a history of cardiovascular diseases, including heart disease and peripheral artery disease, increase the risk of carotid artery disease.

 

It's important to note that while these risk factors contribute to the development of carotid artery disease, their presence does not necessarily mean that an individual will develop the condition. Adopting a healthy lifestyle, managing modifiable risk factors, and working closely with healthcare professionals can help reduce the risk of carotid artery disease and related complications.

It's important to note that carotid artery disease may progress silently without causing any symptoms until a severe blockage or stroke occurs. Therefore, if you have risk factors for carotid artery disease, such as high blood pressure, high cholesterol, smoking, diabetes, or a family history of the condition, it is essential to undergo regular check-ups and screenings with your healthcare provider.

 

Carotid artery disease refers to the narrowing or blockage of the carotid arteries, which are major blood vessels located in the neck that supply blood to the brain. When the carotid arteries become diseased, it can lead to reduced blood flow to the brain and potentially increase the risk of stroke. The symptoms of carotid artery disease can vary depending on the severity of the blockage and whether it is causing a reduction in blood flow. Common symptoms include:

 

Asymptomatic

No symptoms

 

Transient Ischemic Attack (TIA) or Mini-Stroke

A TIA is a temporary episode that mimics stroke symptoms but resolves within 24 hours. It can manifest as sudden weakness, numbness, or paralysis in the face, arm, or leg, typically on one side of the body. Other TIA symptoms may include slurred speech, difficulty understanding or expressing words, blurred vision, dizziness, or loss of balance.

 

Stroke

If the carotid artery disease progresses and a complete blockage or severe narrowing occurs, it can lead to a stroke. Stroke symptoms often develop suddenly and may include severe headache, confusion, difficulty speaking or understanding speech, sudden weakness or numbness on one side of the body, loss of coordination, trouble walking, or visual disturbances.

​

Transient Monocular Blindness (Amaurosis Fugax)

In some cases, carotid artery disease can cause temporary vision loss in one eye, which typically lasts for a few minutes. This symptom occurs due to a temporary reduction in blood flow to the retina.

 

Carotid Bruits

Carotid artery disease can produce an abnormal sound, known as a carotid bruit, which can be heard with a stethoscope placed over the carotid artery in the neck. A bruit may indicate turbulent blood flow caused by narrowed or blocked arteries.

 

Silent Carotid Artery Disease

It's important to note that carotid artery disease can also be asymptomatic, meaning no noticeable symptoms are present. This is known as silent carotid artery disease and may be detected during routine medical evaluations or diagnostic tests.

If you suspect carotid artery disease or are experiencing any symptoms related to reduced blood flow to the brain, it is crucial to seek medical attention immediately. Prompt diagnosis and appropriate treatment can help reduce the risk of stroke and manage the condition effectively.

The treatment for carotid artery disease aims to reduce the risk of stroke and manage the underlying condition. The appropriate treatment approach depends on various factors, including the severity of the disease, the presence of symptoms, and individual patient considerations. Treatment options may include:

 

Lifestyle Modifications

Healthy lifestyle changes can help manage carotid artery disease and reduce the risk of complications. These may include quitting smoking, adopting a heart-healthy diet low in saturated fats and cholesterol, regular physical exercise, maintaining a healthy weight, and managing other underlying medical conditions such as high blood pressure, diabetes, and high cholesterol.

 

Medications

Antiplatelet drugs: Medications such as aspirin or clopidogrel are often prescribed to reduce the risk of blood clots forming in the carotid arteries and potentially causing a stroke.

 

Statins

These medications help lower cholesterol levels and stabilize plaques, reducing the progression of carotid artery disease.

 

Blood pressure-lowering medications

Controlling high blood pressure is crucial in managing carotid artery disease and reducing the risk of complications.

 

Carotid Endarterectomy (CEA) 

This surgical procedure involves the removal of the plaque or blockage from the carotid artery. It is typically recommended for individuals with significant carotid artery stenosis (narrowing) and symptoms, or those with moderate stenosis but a high risk of stroke based on other factors. CEA can help restore blood flow and reduce the risk of stroke.

 

Carotid Artery Stenting 

This procedure involves placing a stent, a small metal mesh tube, into the narrowed carotid artery to open the blockage and improve blood flow. Carotid artery stenting may be an alternative treatment option for individuals who are not suitable candidates for carotid endarterectomy due to various reasons, such as age or medical conditions.

 

The choice of treatment is individualized and based on factors such as the severity of carotid artery disease, the presence of symptoms, the patient's overall health, and their individual risk factors. The decision is typically made in consultation with a vascular surgeon or neurologist who specializes in the management of carotid artery disease.

Regular monitoring and follow-up with healthcare professionals are essential to ensure the effectiveness of treatment and to adjust the management plan as needed. It's important for individuals with carotid artery disease to continue taking prescribed medications, make necessary lifestyle changes, and attend regular check-ups to optimise their cardiovascular health and reduce the risk of stroke.