Duplex ultrasound has been successfully used for many years to assess the extracranial carotid vasculature. With the number of endovascular procedures increasing and the improvement in devices over the past decade, the use of stents in the carotid circulation has advanced to offering a non-surgical treatment for carotid artery disease.

Carotid duplex ultrasound is already widely used for surveillance following surgical procedures, and is now being utilized to assess carotid stents to detect restenosis and other abnormalities.

It has been found, however, that using standard criteria to identify restenosis of the carotid artery post stent placement leads to inaccuracies due to the increase of peak systolic velocity through the stent.

At this time, there appears to be no criteria that has been scientifically proven which is widely used. It has been suggested that different stent types have different haemodynamic effects, and that criteria would have to be developed specific to each stent.

Criteria which may be helpful in diagnosing a haemodynamic stenosis will be discussed in the workshop, including focal increase in peak systolic velocity, a demonstrable diameter narrowing using B-mode, colour Doppler or B-flow, and evidence of post-stenotic turbulence.

This workshop will demonstrate the duplex ultrasound examination to assess carotid stents, describe what is required and abnormalities to be aware of and look for during the examination.