The panel met in San Francisco, Calif, October 22–23, 2002, and drew up a consensus statement. A panel of experts from a variety of medical specialties was convened under the auspices of the Society of Radiologists in Ultrasound to arrive at a consensus about the performance of Doppler ultrasonography (US) to aid in diagnosis of internal carotid artery (ICA)stenosis.Endarterectomy decrease the risk of ipsi-lateral hemispheric stroke or death by 53 to 84% as compared to medical treatment.This is due to difficulty in obtaining a correct insonating angle, non-linear or helical flow, or increased velocityon the inside of the curve. Tortuosity can cause apparent velocity increase even although there is no stenosis.At the sixth cervical vertebra, the vertebral artery runs posteriorly to travel upward through the transverse foramen of cervical vertebrae.Two vertebral arteries join, at the base of the skull, to form basilar artery, which then divides to form posterior cerebral arteries. CCA, which has no branches, divides into the internal and external carotid arteries.Carotid artery widens at the level of the bifurcation to form the carotid bulb & degree of widening of carotid bulb is quite variable.Level of the carotid bifurcation in the neck is highly variable.Proximal branches of the ECA are the superior thyroid, lingual, facial and maxillary arteries.Vertebral artery is the first branch of the subclavian artery, arising from the highest point of the subclavian arch.
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