Carotid artery stenosis diagnostic testing guidelines

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]

Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Diagnostic Testing in Patients With Symptoms or Signs of Extracranial Carotid Artery Disease (DO NOT EDIT)

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Class I

1. Noninvasive imaging for detection of ECVD is recommended in the initial evaluation of patients with transient retinal or hemispheric neurological symptoms of possible ischemic origin. (Level of Evidence: C)
   1. Duplex ultrasonography is recommended to detect carotid stenosis in patients who develop focal neurological symptoms corresponding to the internal carotid artery territory. (Level of Evidence: C)
      1. In patients with acute, focal ischemic neurological symptoms corresponding to the territory supplied by the left or right internal carotid artery, magnetic resonance angiography (MRA) or computed tomography angiography (CTA) is indicated to detect carotid stenosis when definitive sonography cannot be obtained. (Level of Evidence: C)