Normal Carotid Duplex Report Template

Normal carotid duplex ultrasound report template with PSV/EDV velocity table wording, ICA/CCA ratio and vertebral artery flow direction.

EXAMINATION: Carotid duplex ultrasound, bilateral.

CLINICAL HISTORY: [indication]

COMPARISON: None available.

TECHNIQUE: Real-time grayscale, color and spectral Doppler imaging of the
extracranial carotid and vertebral arteries.

FINDINGS:
Right carotid system: No plaque. CCA PSV [x] cm/s. ICA PSV [x] cm/s, EDV
[x] cm/s. ICA/CCA ratio [x]. Normal spectral waveforms.
Left carotid system: No plaque. CCA PSV [x] cm/s. ICA PSV [x] cm/s, EDV
[x] cm/s. ICA/CCA ratio [x]. Normal spectral waveforms.
Vertebral arteries: Antegrade flow bilaterally.

IMPRESSION:
1. No hemodynamically significant stenosis in either carotid system
(less than 50% by velocity criteria).
2. Antegrade vertebral flow bilaterally.

Dictation notes

• State the velocity criteria set in use; consensus criteria differ between labs and accreditation reviews check for it.
• Retrograde or to-and-fro vertebral flow is a subclavian steal until proven otherwise — never bury it in the table.

Frequently asked questions

What measurements belong in a carotid duplex report?

A carotid duplex report gives, for each side, the presence or absence of plaque, the CCA and ICA peak systolic velocities, the ICA end-diastolic velocity, the ICA/CCA PSV ratio and the spectral waveform character, plus the direction of vertebral artery flow. A normal impression states no hemodynamically significant stenosis — less than 50% by velocity criteria — and antegrade vertebral flow bilaterally.

Why should a carotid report state which velocity criteria were used?

Velocity thresholds for grading carotid stenosis differ between laboratories — consensus criteria, locally validated criteria and society updates do not agree exactly — and accreditation reviews check that the report names the criteria set in use. Stating it makes the stenosis grade reproducible: a given ICA peak systolic velocity maps to different percentage categories under different schemes, so the number alone is not self-interpreting.

What does retrograde vertebral artery flow mean?

Retrograde or to-and-fro vertebral artery flow suggests subclavian steal — a proximal subclavian or innominate stenosis causing the vertebral artery to supply the arm — until proven otherwise. It deserves its own line in the impression rather than being buried in the velocity table, and correlation with arm blood pressure differential and symptoms guides whether further arterial imaging is needed. Normal studies state antegrade flow bilaterally.

← All report templates