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Dr Harry Gibbs MB BS, FRACP

Carotid duplex scanning (CDS) has been used in clinical practice for over 20 years. It now has an established role in the diagnosis of extracranial atherosclerotic cerebrovascular disease (CVD). Important management decisions including the decision to proceed to carotid endarterectomy can be made on the basis of CDS alone in many cases. This obviates the need for angiography which carries a resk of stroke of about 1%. CVD is the commonest pathology affecting the extracranial circulation and is a major, preventable cause of stroke. There are a number of less common conditions affecting the carotid arteries, however, which may also be associated with the devastating complications of blindness of stroke. Accurate diagnosis is essential in these cases to allow the commencement of appropriate therapy. This article reviews the role of CDS in the diagnosis of these less common conditions and also in patients who have undergone previous carotid endarterectomy.

CONCLUSION
CDS is a valuable examination of the extracranial cerebrovascular arteries. The majority of studies are performed to diagnose the extent and severity of CVD. CDS has an extended role in the diagnosis of unusual carotid pathologies where it provides vital information that is often complementary to other imaging modalities and which aids clinical management.

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