Ultrasound and echo-Doppler investigation in carotid artery disease

Advances in our understanding of the pathophysiology of cerebrovascular disease has enhanced the clinical importance of functional exploration of the extracranial carotid artery. Primary preventive strategies, aimed at controlling cardiovascular risk factors, are accompanied by secondary measures which include early diagnosis in the initial or preclinical stages to ensure prompt medical management and appropriate selection of surgical candidates Non-invasive ultrasound investigation of the afferent cerebral vessels remains the first examination in the diagnostic work-up. Detailed and reliable assessment of parietal disease is accompanied by exploration of haemodynamics by the Doppler effect. The latest generation of echo-colour-Doppler devices combine structural analysis of atheromasic plaque and the estimate of the haemodynamic import of a lesion with reliable measurements of flow velocity and volume by means of targetted endovascular sampling, or whole field scanning. The limitations of ultrasound diagnosis are owing to intrinsic (dependence on operator skill, attenuation of the ultrasound beam caused by tissue calcium) and variations in the individual patient and site to be examined (the carotid cannot be visualized distal to the jaw bone). Echo-Doppler investigation is actually the most effective screening and follow-rep rest in the study carotid atherosclerotic disease and the haemodynamics of a lesion.