Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) (STR, RAD)
CPT4 code
Name of the Procedure:
Carotid Imaging Study Report (CISR)
Summary
A Carotid Imaging Study Report is a medical examination used to visualize the carotid arteries, which supply blood to the brain. This procedure is essential for measuring the diameter of the distal internal carotid artery to determine the degree of stenosis (narrowing) and assess the risk of stroke.
Purpose
The primary purpose of a Carotid Imaging Study is to detect and evaluate blockages or narrowing in the carotid arteries. By accurately measuring the degree of stenosis, healthcare professionals can plan appropriate treatments to prevent strokes and other complications associated with poor blood flow to the brain.
Indications
- Symptoms like transient ischemic attacks (TIA), stroke, or mini-strokes.
- Presence of bruit (an abnormal sound) over the carotid artery.
- Patients with risk factors for atherosclerosis such as hypertension, diabetes, high cholesterol, or smoking.
- Follow-up for known carotid artery disease.
Preparation
- Fasting is generally not required.
- Patients may need to adjust medications, particularly blood thinners, as advised by their doctor.
- Prior to the procedure, patients may undergo blood tests, and their medical history will be reviewed.
Procedure Description
- The patient lies on a bed, and a clear gel is applied to the neck.
- A transducer (ultrasound probe) is moved over the carotid arteries.
- Ultrasound waves create detailed images of the arteries.
- Measurements are taken of the distal internal carotid diameter to evaluate stenosis.
- In some cases, contrast dye may be used in advanced imaging techniques like CT or MRI for enhanced visibility.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
Carotid imaging studies are performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist or vascular specialist who interprets the results.
- Ultrasound technician who conducts the imaging.
- Nurses or other medical staff for patient preparation and support.
Risks and Complications
- Generally low-risk.
- Rarely, allergic reactions to contrast dye (if used).
- Minor discomfort or irritation from the ultrasound gel.
Benefits
- Accurate assessment of carotid artery stenosis.
- Helps prevent strokes by guiding treatment options.
- Non-invasive and usually painless.
Recovery
- The patient can resume normal activities immediately after the procedure.
- Follow-up instructions will depend on the findings and recommendations of the radiologist.
Alternatives
- CT Angiography (CTA)
- Magnetic Resonance Angiography (MRA)
- Carotid Artery Doppler Ultrasound
- Each alternative has its pros and cons related to invasiveness, detail, and patient health status.
Patient Experience
During the procedure, the patient will feel minimal discomfort. The gel might feel cold, and slight pressure from the transducer may be observed. Post-procedure, there's no downtime, and any discomfort from the gel will subside quickly.