Duplex Ultrasonography of the Carotid Bifurcation

Carotid duplex ultrasonography for initial and serial imaging of the carotid bifurcation remains an essential component in the management of carotid bifurcation disease in light of other imaging modalities. 

This educational activity will provide detailed guidelines and performance protocols, as well as updated diagnostic criteria in the classification of disease and clinical management of carotid bifurcation atherosclerosis.  

Original Release Date: March 2021
Review Date: February 2023

Target Audience

Cardiologists, vascular surgeons, interventional radiologists, nurses, nurse practitioners, physician assistants, respiratory therapists (personal growth), echocardiography and noninvasive vascular testing specialists and sonographers.

Learning Objectives

  • Describe atherosclerotic plaque on an ultrasound image.
  • Demonstrate spectral Doppler imaging criteria used in the classification of carotid artery stenosis.
  • Recognize limitations of duplex ultrasonography imaging.
  • Explain the need to correlate with other diagnostic modalities.
Additional information
Bibliography: 
  • Grant, E. G., Benson, C. B., Moneta, G. L., Alexandrov, A. V., Baker, J. D., Bluth, E. I., Carroll, B. A., Eliasziw, M., Gocke, J., Hertzberg, B. S., Katanick, S., Needleman, L., Pellerito, J., Polak, J. F., Rholl, K. S., Wooster, D. L., & Zierler, R. E. (2003). Carotid artery stenosis: gray-scale and Doppler US diagnosis--Society of Radiologists in Ultrasound Consensus Conference. Radiology, 229(2), 340–346. 
  • Sacco, R.L., Kargman, D. E., Gu, Q., & Zamanillo, M.C. (1995). Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the North Manhattan Stroke Study. Stroke, 26(1), 14-20.
  • Longstreth, Jr., W. T., Shemanski, L., Lefkowitz, D., O'Leary, D. H., Polak, J. R., & Wolfson Jr., S.K. (1998).  Asymptomatic internal carotid artery stenosis defined by ultrasound and the risk of subsequent stroke in the elderly: the Cardiovascular Health Study. Stroke, 29(11), 2371-2376.
Course Summary
Available credit: 
  • 1.00 ABS MOC II
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.00 Florida Board of Respiratory Therapy
Course opens: 
03/01/2021
Course expires: 
01/31/2024
Part of: 
Vascular Testing e-Learning Series

Constantino S. Peña, M.D., FSIR, FAHA, FSCCT
Medical Director of Vascular Imaging
Interventional Radiologist
Miami Cardiac & Vascular Institute
Baptist Health South Florida
Clinical Assistant Professor of Radiology
Florida International University Herbert Wertheim College of Medicine
Collaborative Associate Professor of Radiology
University of South Florida College of Medicine

Muhammad Hasan, MBBCh, RPVI, RVT, RDCS, RDMS
Cardiovascular Clinical Education and Credentialing 
Miami Cardiac & Vascular Institute 
Baptist Health South Florida

Constantino S. Peña, M.D., faculty of this educational activity, is a consultant for Penumbra, Philips Healthcare and Avanos, and a member of the speakers’ bureau for Cook, Cordis, Shockwave and BD, and has indicated that this presentation or discussion will not include off-label or unapproved product usage. 

Muhammad Hasan, MBBCh, RPVI, RVT, RDCS, RDMS, faculty and conference director of this educational activity, has no relevant financial relationships with ineligible companies* to disclose and has indicated that this presentation or discussion will not include off-label or unapproved product usage.

Elliott J. Elias, M.D., conference director, disclosed that he is a member of the speakers’ bureau for Abbott Laboratories. 

Brian J. Schiro, M.D., conference director, disclosed that he receives grant/research support from Medtronic and that he is a member of the speakers’ bureau for Penumbra. 

All of the relevant financial relationships listed for these individuals have been mitigated.

Other individuals involved in planning, content review, approval, or moderating for this educational activity have no relevant financial relationships to disclose with ineligible companies*. 

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.              

Baptist Health South Florida designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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American Board of Surgery - Maintenance of Certification (MOC) - Accredited CME -  Vascular Surgery

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Your participation information will be shared with specialty boards through the ACCME's PARS reporting system. Successful completion of a course examination is required. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

Available Credit

  • 1.00 ABS MOC II
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.00 Florida Board of Respiratory Therapy
Please login or register for a Baptist Health CME account to take this course.

Required Hardware/Software

PC/Mac Users
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Mobile Users
Mobile Users

This site is supported on the following mobile devices:

  • Apple iOS mobile devices running iOS 10 or later
  • Android mobile devices running Android 4.4 or later, with the latest release of Google Chrome or Mozilla Firefox
Technical Support
Technical Support

If you are experiencing technical difficulties or have received an error message, please send an email to CME@baptisthealth.net and include a print screen of the error message, your browser name and version, username and URL where the error occurred. You can expect a response within 48 hours.