Unilateral CarotidVertebral Duplex Study

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Unilateral Carotid/Vertebral Duplex Study

• Montgomery College
• DMS 2004

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Normal Anatomy
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Normal Anatomy
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Carotid duplex normal protocol

• Scan from the origin of the CCA to the most
  distal aspect in transverse and longitudinal
• Scan the ICA and ECA from their origin at the
  carotid bifurcation and follow each vessel as
  superiorly as possible
• Scan vertebral arteries from their origin to
  their most distal aspect
• After documenting normal anatomy with gray scale,
  apply color and pulsed wave Doppler on images to
  demonstrate blood flow dynamics

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Scanning tips and techniques

• Use a 7.5 to 10 MHz transducer
• Have a patient lay flat on his/her back
• Place a pillow behind the patients shoulders (or
  no pillow) and turn the patients head to the
  side opposite the one you are scanning
• Hold transducer at the base so you can use your
  fingers as a guide on the patients neck
• Note most disease occurs at the carotid
  bifurcation

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Sag Lt Common Carotid Artery
Prox - Mid
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Sag Lt Common Carotid Artery
Distal
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Sagittal Lt Bifurcation
ECA/ICA
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ECA vs. ICA
ECA extracranial branches high- resistance
waveform temporal taps ICA no extracranial
branches low-resistance waveform
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Bulb/ICA/ECA with STA branch
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Lt CCA Bifurcation / ECA
with STA Branch
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CCA BifurcationECA / ICA
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Sag Lt Internal Carotid Artery
Posterior Projection
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Sag Lt Internal Carotid Artery
Anterior Projection
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Sagittal Lt Vertebral Artery
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Sagittal Lt Vertebral Artery
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Sagittal Lt Vertebral Artery
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Sagittal Lt Vertebral Artery
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Transverse Lt CCA Proximal
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Transverse Lt CCA Mid
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Transverse Lt CCA Dist
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Transverse Lt CCA Bulb
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Transverse Lt ICA / ECA
Prox
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Transverse Lt ICA / ECA
Mid
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Transverse Lt ICA / ECA
Distal
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Pulsed-Wave Doppler Lt
CCA Prox
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Pulsed-Wave Doppler Lt
CCA Mid
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Pulsed-Wave Doppler Lt
CCA Dist
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Pulsed-Wave Doppler
Lt ECA
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Pulsed-Wave Doppler
Lt ECA
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Pulsed-Wave Doppler
Lt ICA Origin
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Pulsed-Wave Doppler Lt
ICA Prox
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Pulsed-Wave Doppler
Lt ICA Mid
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Pulsed-Wave Doppler
Lt ICA Dist
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Pulsed-Wave Doppler Lt
Vertebral Artery