Table 2.1

Limited Screening Study for Carotid Artery Plaque—Asymptomatic

IndicationAppropriate Use Score (1–9)
30.
  • Low Framingham risk score

  • No prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement

I (2)
31.
  • Intermediate Framingham risk score

  • No prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement

U (4)
32.
  • Low or intermediate Framingham risk score

  • Normal prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement

I (3)
33.
  • High Framingham risk score

U (5)

A = appropriate; I = inappropriate; IMT = intima-media thickness; U = uncertain.

  • A screening carotid duplex examination includes assessment for the presence of atherosclerotic plaque within the common and internal carotid arteries using grey-scale imaging and assessment for stenosis of the proximal internal carotid artery using spectral Doppler. The screening carotid duplex examination is performed using a limited but clearly defined screening protocol (see ICAVL 2010 standards 5.1.5) (3). A screening study for carotid artery plaque does not include formal measurement of carotid intimal medial thickness.