Abstract
The extracranial arterial circulation, with particular reference to the carotid bifurcation, is well recognized as a common site for the development of atherosclerosis. It is also known that lesions at this site are a major cause of stroke, which remains the third most common cause of death in the USA. Until ultrasound (US) became available, the only method that could be used to visualize the area was arteriography, which is invasive, painful and potentially dangerous. Duplex US scanning has been very useful for identifying disease in this area and determining the degree of diameter reduction, which is the most important predictor of a stroke. Duplex US has proven so reliable that increasing numbers of surgeons are willing to proceed with carotid endarterectomy on the basis of US studies alone. This represents a major advance, both in terms of a reduction in cost and also in safety for the patient. This trend will continue because there is no evidence that patient care suffers by using this approach.
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