Recognition of carotid artery disease.

Ultrasound scanning of the carotid arteries in the neck was carried out in twelve hundred and eighty eight patients from 1979-1984 leading to 80 carotid endarterectomies. An ATL Duplex scanner was used to show localised atheroma at the origin of the internal carotid artery. In an arteriographic study, a localised carotid murmur was identified in 51 of 117 (44%) of carotid ulcers/stenoses. Major complications of 135 carotid angiograms included one death (0.7%) and four strokes (3%). Duplex scanning is a safe and rapid screening method for detecting carotid atheroma. With a current annual work load of 300 scans, 45 arteriograms and 15 endarterectomies, the screening/treatment ratio is 20:1.