Duplex Ultrasound Surveillance After Carotid Endarterectomy

Surveillance after carotid endarterectomy or carotid artery stenting has been common practice established based on historical evidence for ipsilateral restenosis, contralateral disease progression, and associated stroke rates. In today’s practice, whether carotid restenosis is associated with an increased risk of ipsilateral stroke and the need for surveillance after a carotid intervention have been challenged. Yet, duplex surveillance for carotid interventions remains a simple and effective strategy that does not necessarily prevent a stroke but establishes a follow-up culture for contralateral disease and overall cardiovascular risk assessment. Following a baseline postoperative carotid duplex, a surveillance strategy can be individualized based on the risk profile of the patient.