The use of widespread screening or routine ultrasound for blocked neck arteries isn't necessary to determine stroke risk, according to new guidelines from a number of organizations.
Instead, ultrasound should be used only in people with symptoms or other stroke risk factors, according to guidelines produced by the American Heart Association/American Stroke Association, the American College of Cardiology, and other groups.
Stroke risk factors include age, family history of stroke, high blood pressure, high blood cholesterol, diabetes, obesity, atrial fibrillation, physical inactivity, sickle cell disease, and other heart or blood vessel diseases.
In other recommendations, the groups also noted that carotid endarterectomy and carotid stenting are both reasonable and safe treatment methods when arteries are more than 50% blocked. And medications offer a better alternative than either surgery or stenting for many patients, according to the guidelines.
The full text of the guidelines is set to be published in Circulation: Journal of the American Heart Association; Stroke: Journal of the American Heart Association; and the Journal of the American College of Cardiology.
Related Reading
CT equal to MRI for spotting perfusion abnormalities after TIA, January 14, 2011
CT predicts hemorrhagic transformation in stroke patients, December 22, 2010
MDCT of heart and arteries aids etiologic workup of ischemic stroke, November 9, 2010
Study finds diffusion-weighted MRI tops CT in diagnosing stroke, July 12, 2010
Volume helical shuttle CT perfusion identifies stroke patients, April 20, 2010
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)