Carotid artery stenosis a physician detects a carotid bruit, or murmur, over the carotid artery by listening through a stethoscope during a physical exam. For people with symptoms, the American Heart Association recommends initial screening using ultrasound (see diagnosis below). Carotid artery stenosis is usually diagnosed by color flow duplex ultrasound scan of the carotid arteries in the neck. This involves no radiation, no needles and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity. Typically duplex ultrasound scan is the only investigation required for decision making in carotid stenosis as it is widely available and rapidly
Intima-media thickness not satisfactory. IMT can be measured using external ultrasound in large arteries relatively close to the skin (e.g. the carotid, brachial, radial, or femoral arteries). External ultrasound methods have the advantage of being non-invasive, comparatively low cost and convenient. Deeper internal arteries, such as the coronary arteries require special intravascular catheters employing ultrasound or optical coherence tomography to measure IMT. The carotid artery is the usual site of measurement of IMT and consensus statements for carotid IMT have been published for adults and children. Often, IMT is measured in three locations: in the common carotid artery (typically at one cm