Diagnostic modalities for carotid artery disease.

Stroke secondary to atherosclerosis is one of the most common causes of death in the United States. A major cause of thromboembolic stroke is atherosclerotic narrowing and ulceration in the region of the carotid bifurcation. The indication for carotid surgery may or may not include the presence of symptoms, but all indications include the presence of an atherosclerotic plaque that may result in embolic or occlusive disease. Because the protective results of surgery depend on accurately defining the presence of these plaques and the degree of carotid artery stenosis, it is essential to understand the diagnostic methods used in determining carotid disease and grading carotid artery stenosis. An understanding of their reliability and associated risks is essential for the proper management of patients with carotid bifurcation disease.