Carotid duplex ultrasound after carotid stenting

Nature of the scan Generally, a follow-up scan after a carotid stenting procedure is performed for the surveillance of the stent, not for monitoring of the untreated contralateral carotid. Hence, if the contralateral artery is not significantly stenosed, we perform ipsilateral scans only (i.e. “targeted US”). Since the distal/cephalic end of the carotid stent can be placed well distal/cephalic to the point accessible at open carotid endarterectomy, Duplex US after carotid stenting often requires the use of a sector probe to visualise the distal end of the stent and the internal carotid artery (ICA) beyond it. This is particularly true in that one of the strong indications for carotid stenting (as opposed to endarterectomy) is the presence of a high carotid bifurcation, placing the distal end of the stent even closer to the skull base. Finally, the timing of the scan in relationship to the date of the carotid stenting operation has an important bearing on the type of stenosis encountered.