Imaging the Carotid Bifurcation: Toward Standardization

Treatment of extracranial carotid artery disease has been one of the most hotly debated topics in vascular medicine. Imaging of the carotid bifurcation remains an important first step in the therapeutic decision-making process. Successful determination of the severity of carotid artery stenosis depends on several factors, including the skill and expertise of the technologists obtaining the images and the physicians providing an interpretation of the data; knowledge of the advantages and pitfalls of the specific technology; and the need for correlative imaging based on initial test findings. This article will highlight the current strategies for carotid bifurcation imaging and will provide a diagnostic algorithm useful for centers involved in the management of carotid artery disease.