{"product_id":"carotid-artery-narrowing-without-symptoms-how-modern-ultrasound-predicts-stroke-risk","title":"Carotid Artery Narrowing Without Symptoms: How Modern Ultrasound Predicts Stroke Risk","description":"\u003cp\u003eDoctors now understand that advanced ultrasound technology can do much more than simply measure how narrowed a carotid artery is—it can also reveal the hidden \"vulnerable\" features of plaque that raise a person's risk for stroke. This review article from University Hospital Basel explains why best medical therapy has dramatically lowered stroke rates in patients with asymptomatic carotid stenosis, and why surgery or stenting is no longer routinely recommended for everyone. Crucially, certain ultrasound findings—including plaque that appears dark, grows quickly, has an irregular surface, or develops new blood vessels inside it—may help identify the smaller group of patients who could still benefit from an intervention. For patients, this shift means more personalized risk assessment and a renewed emphasis on medications, blood pressure control, cholesterol management, and smoking cessation.\u003c\/p\u003e\n\n\u003ch1\u003eCarotid Artery Narrowing Without Symptoms: How Modern Ultrasound Predicts Stroke Risk\u003c\/h1\u003e\n\n\u003ch2\u003eTable of Contents\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\u003ca href=\"#ddn-key-points\"\u003eKey Points\u003c\/a\u003e\u003c\/li\u003e\n\n  \u003cli\u003e\u003ca href=\"#background\"\u003eBackground: The Silent Danger of Carotid Stenosis\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ultrasound-role\"\u003eThe Role of Duplex Ultrasound: A First-Line Detection Tool\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#medical-therapy\"\u003eBest Medical Therapy: The Foundation of Care for Every Patient\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#declining-stroke-rates\"\u003eDeclining Stroke Rates: A Turning Point in Treatment Strategy\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#beyond-grade\"\u003eBeyond the Degree of Narrowing: Why Plaque Character Matters\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#vulnerable-plaque-features\"\u003eUltrasound Features of a Vulnerable Carotid Plaque\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#clinical-implications\"\u003eClinical Implications: Who Might Still Need Surgery or Stenting?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#limitations\"\u003eLimitations of the Current Evidence\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#recommendations\"\u003eRecommendations for Patients\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ddn-faq\"\u003eFrequently Asked Questions\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#source\"\u003eSource Information\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003c!-- ddn:keypoints:start --\u003e\n\u003ch2 id=\"ddn-key-points\"\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eAll patients with asymptomatic carotid stenosis need medical therapy.\u003c\/li\u003e\n\u003cli\u003eStroke rates in asymptomatic carotid stenosis have declined due to better medications.\u003c\/li\u003e\n\u003cli\u003ePlaque character, not just narrowing degree, helps predict stroke risk.\u003c\/li\u003e\n\u003cli\u003eHigh-risk plaque features include dark appearance, ulceration, and intraplaque blood vessels.\u003c\/li\u003e\n\u003cli\u003eSurgery or stenting is reserved for patients with high-risk plaque features or progression.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c!-- ddn:keypoints:end --\u003e\n\n\n\u003ch2 id=\"background\"\u003eBackground: The Silent Danger of Carotid Stenosis\u003c\/h2\u003e\n\n\u003cp\u003eThe carotid arteries are the two main blood vessels on each side of your neck that carry oxygen-rich blood to your brain. When fatty deposits, or plaques, build up inside these arteries, the condition is known as \u003cstrong\u003ecarotid stenosis\u003c\/strong\u003e (narrowing of the carotid artery). \u003c\/p\u003e\n\n\u003cp\u003eMany people live with carotid stenosis without experiencing any warning signs. When the narrowing is discovered incidentally—for example, during a routine ultrasound for an unrelated reason—it is called \u003cstrong\u003easymptomatic carotid stenosis (ACS)\u003c\/strong\u003e. The word \"asymptomatic\" means the patient has not experienced a transient ischemic attack (TIA, sometimes called a \"mini-stroke\") or a stroke on the side of the brain served by that artery.\u003c\/p\u003e\n\n\u003cp\u003eThe danger is real, however. The review explains that \u003cstrong\u003edistal embolization originating from an ipsilateral asymptomatic carotid stenosis is the cause of a substantial proportion of first-ever ischemic strokes\u003c\/strong\u003e. In plain terms: tiny pieces of plaque or blood clots can break off from the narrowed artery (on the same side of the neck as the stroke) and travel downstream into the brain, blocking a smaller blood vessel and causing a stroke. This is often a person's very first stroke—there are no prior warnings.\u003c\/p\u003e\n\n\u003ch2 id=\"ultrasound-role\"\u003eThe Role of Duplex Ultrasound: A First-Line Detection Tool\u003c\/h2\u003e\n\n\u003cp\u003eWhen a doctor suspects carotid artery disease, or when a patient has risk factors such as high blood pressure, diabetes, smoking, or high cholesterol, the first imaging test recommended is \u003cstrong\u003eduplex ultrasound\u003c\/strong\u003e. This is a painless, non-invasive test that combines two techniques in a single examination:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eB-mode ultrasound (brightness mode):\u003c\/strong\u003e Produces a two-dimensional grayscale image showing the anatomy of the artery wall and any plaque attached to it.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDoppler ultrasound:\u003c\/strong\u003e Measures the speed and direction of blood flowing through the artery. When a vessel is narrowed, blood moves faster through the tight spot, and these flow velocity changes allow the doctor to estimate the degree of stenosis (percentage of blockage).\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eDuplex ultrasound is recommended as the \u003cstrong\u003efirst-line imaging method\u003c\/strong\u003e to detect and evaluate the extent and severity of extracranial carotid stenoses—that is, narrowing of the carotid arteries in the neck, outside the skull.\u003c\/p\u003e\n\n\u003cp\u003eThis is considered an extension of the physical exam. The ultrasound is widely available, does not involve radiation or contrast dye injections, can be repeated safely over time to monitor changes, and provides valuable information about both the severity of the narrowing and the nature of the plaque itself. The review article categorizes the severity of stenosis based on \u003cstrong\u003ehemodynamic criteria\u003c\/strong\u003e, which simply means blood-flow measurements obtained through Doppler ultrasound.\u003c\/p\u003e\n\n\u003ch2 id=\"medical-therapy\"\u003eBest Medical Therapy: The Foundation of Care for Every Patient\u003c\/h2\u003e\n\n\u003cp\u003eThe review is unequivocal on one point: \u003cstrong\u003eall patients with asymptomatic carotid stenosis need best cardiovascular medical therapy\u003c\/strong\u003e. This is not an optional recommendation—it applies to every single patient, regardless of whether they ultimately undergo a procedure. The components of this therapy include:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eSmoking cessation strategies:\u003c\/strong\u003e Smoking is a major driver of atherosclerosis, and quitting is one of the most impactful steps a patient can take.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eStatins:\u003c\/strong\u003e These cholesterol-lowering medications do more than lower \"bad\" LDL cholesterol—they also stabilize plaque, making it less likely to rupture and send debris to the brain.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAntihypertensive drugs:\u003c\/strong\u003e Lowering blood pressure reduces the force of blood flow against the plaque and decreases the risk of a stroke-causing event.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAntiplatelet therapy:\u003c\/strong\u003e Medications such as low-dose aspirin or clopidogrel reduce the ability of blood platelets to clump together and form clots that could break off and travel to the brain.\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThis combination of therapies addresses the underlying disease process throughout the entire body, not just in the carotid artery. Patients with ACS typically have atherosclerosis elsewhere, so treating the whole vascular system provides far-reaching protection against heart attacks and other vascular events.\u003c\/p\u003e\n\n\u003ch2 id=\"declining-stroke-rates\"\u003eDeclining Stroke Rates: A Turning Point in Treatment Strategy\u003c\/h2\u003e\n\n\u003cp\u003eOne of the most important developments in recent years is that the risk of stroke in patients with asymptomatic carotid stenosis has fallen dramatically. The review states that the \u003cstrong\u003eannual stroke rate in patients with ACS has significantly declined during the last years due to improvement in medical therapy\u003c\/strong\u003e.\u003c\/p\u003e\n\n\u003cp\u003eWhy does this matter? For decades, the standard approach to a high-grade asymptomatic carotid stenosis (typically a blockage of 60% to 99%) was to offer a preventive procedure—either \u003cstrong\u003ecarotid endarterectomy\u003c\/strong\u003e (surgical removal of the plaque) or \u003cstrong\u003ecarotid stenting\u003c\/strong\u003e (placing a mesh tube to hold the artery open). The logic was straightforward: if the artery is severely narrowed, fix it before it causes a stroke.\u003c\/p\u003e\n\n\u003cp\u003eBut as medical therapy improved, the risk-to-benefit equation shifted. The risk of stroke from the stenosis itself dropped substantially, to the point where, for many patients, the risks of the procedure (which include surgical stroke, heart attack, nerve injury, and bleeding) began to outweigh the potential benefit. The review concludes that \u003cstrong\u003esurgical prophylactic carotid endarterectomy or carotid stenting are no longer recommended routinely in all patients with high-grade ACS\u003c\/strong\u003e.\u003c\/p\u003e\n\n\u003cp\u003eThis is a personalized medicine message: blanket recommendations for surgery have been replaced by an individualized approach that takes into account each patient's specific risk profile.\u003c\/p\u003e\n\n\u003ch2 id=\"beyond-grade\"\u003eBeyond the Degree of Narrowing: Why Plaque Character Matters\u003c\/h2\u003e\n\n\u003cp\u003eThe traditional way to gauge stroke risk in patients with carotid stenosis has been to measure how severely the artery is narrowed, using the hemodynamic (blood-flow) criteria on duplex ultrasound. A 70% stenosis was considered riskier than a 50% stenosis, and so on. The degree of narrowing is still important, but the review emphasizes that it is no longer the only—or even the most important—factor.\u003c\/p\u003e\n\n\u003cp\u003eSeveral studies now demonstrate that \u003cstrong\u003enot only the grade of stenosis based on hemodynamic criteria on duplex ultrasound increases the ipsilateral stroke risk, but also morphological characteristics\u003c\/strong\u003e are associated with more vulnerable plaque and a higher risk of stroke. In other words, a moderately narrowed artery containing a dangerous, unstable plaque could pose a greater threat than a severely narrowed artery containing a stable, calcified plaque.\u003c\/p\u003e\n\n\u003cp\u003eThe concept of the \u003cstrong\u003evulnerable plaque\u003c\/strong\u003e has transformed how doctors think about stroke prevention. A vulnerable plaque is one that is prone to rupture or erosion. When it breaks apart, debris and clots are released into the bloodstream and travel to the brain. The review highlights that morphological features visible on ultrasound may help identify which plaques are truly dangerous.\u003c\/p\u003e\n\n\u003ch2 id=\"vulnerable-plaque-features\"\u003eUltrasound Features of a Vulnerable Carotid Plaque\u003c\/h2\u003e\n\n\u003cp\u003eThe review identifies several specific ultrasound findings that have been studied as predictors of a vulnerable, higher-risk carotid stenosis. These are features that can be seen either during the standard B-mode ultrasound examination or during a more advanced technique called \u003cstrong\u003econtrast-enhanced ultrasound\u003c\/strong\u003e (in which a harmless microbubble contrast agent is injected into a vein to highlight blood flow within the plaque itself).\u003c\/p\u003e\n\n\u003cp\u003eThe key risk features identified in the review are:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eA high progression rate of the grade of stenosis on duplex ultrasound:\u003c\/strong\u003e If follow-up ultrasounds show that the narrowing is rapidly worsening over time, this suggests an unstable process that may be more likely to cause a stroke.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eHypoechogenicity on B-mode ultrasound:\u003c\/strong\u003e This means the plaque appears darker on the grayscale image. Dark appearance indicates a soft, lipid-rich (fatty) plaque rather than a hard, calcified one. Such soft plaques are more prone to rupture.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eHigher plaque area:\u003c\/strong\u003e The overall size of the plaque, measured on ultrasound images, correlates with the burden of disease and with stroke risk.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eSurface irregularities and ulceration on B-mode ultrasound:\u003c\/strong\u003e A smooth plaque surface is more stable. An irregular, rough surface—or one with a visible ulcer (a crater-like defect)—is a dangerous sign. Ulcers act as sites where clots can form and break off.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eIntraplaque vascularization on contrast-enhanced ultrasound:\u003c\/strong\u003e Healthy plaques have very few blood vessels inside them. When new, fragile microvessels grow into the plaque (a process called neovascularization or intraplaque vascularization), they can bleed, causing the plaque to expand or rupture. Contrast-enhanced ultrasound can visualize these tiny vessels, and their presence is a marker of vulnerability.\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eWhy are these features so relevant? Because they reflect the biology of the plaque—what it is actually made of and how unstable it is—rather than just the physical narrowing it causes. A patient whose artery is only 50% narrowed but has an ulcerated, hypoechoic plaque with intraplaque vascularization may face a higher stroke risk than a patient with a 90% narrowing but a smooth, calcified, stable plaque.\u003c\/p\u003e\n\n\u003ch2 id=\"clinical-implications\"\u003eClinical Implications: Who Might Still Need Surgery or Stenting?\u003c\/h2\u003e\n\n\u003cp\u003eThese additional morphological features are not purely academic. The review notes that they \u003cstrong\u003emay be useful to select a subgroup of patients with ACS who may benefit from interventions\u003c\/strong\u003e.\u003c\/p\u003e\n\n\u003cp\u003eIf a patient has high-risk plaque features, the estimated stroke risk from the carotid disease may exceed the risk of surgery or stenting, making a procedure worthwhile. Conversely, if a patient has a highly calcified, stable plaque and no adverse features, the expected benefit of a procedure would be very small, and medical therapy alone would be the safest and most appropriate path.\u003c\/p\u003e\n\n\u003cp\u003eIn practice, this means that the decision to proceed with carotid endarterectomy or carotid stenting is becoming more nuanced. The modern cardiovascular team—composed of vascular surgeons, interventional radiologists, cardiologists, and angiologists—weighs the patient's overall life expectancy, the degree of stenosis, the morphology of the plaque, and the center's own surgical complication rates before making a recommendation.\u003c\/p\u003e\n\n\u003cp\u003eThis is important information for patients facing these decisions. Being told, \"You have a 70% carotid stenosis,\" is no longer enough to make a treatment decision. The ultrasound report must be interpreted in the context of plaque features, disease progression, and overall health.\u003c\/p\u003e\n\n\u003ch2 id=\"limitations\"\u003eLimitations of the Current Evidence\u003c\/h2\u003e\n\n\u003cp\u003eWhile the evidence supporting the role of plaque morphology is growing, the review itself acknowledges that the field still has important gaps. First, the original article is a \u003cstrong\u003ereview article\u003c\/strong\u003e, not a randomized controlled trial—it synthesizes the findings of prior studies rather than contributing new patient data. Second, the predictive value of these ultrasound features, while statistically associated with stroke risk in research studies, has not yet been fully validated in large-scale prospective trials that would allow doctors to confidently assign a precise risk percentage to each patient.\u003c\/p\u003e\n\n\u003cp\u003eThere is also inherent operator variability in ultrasound. Carotid plaque characterization relies on the skill and experience of the sonographer and interpreting physician. The assessment of \"hypoechogenicity\" or \"surface irregularities\" involves a subjective component, although standardized scoring systems are being developed. Contrast-enhanced ultrasound requires intravenous access and the injection of a contrast agent, which is not universally available in all imaging centers.\u003c\/p\u003e\n\n\u003cp\u003eFinally, because stroke rates in medically treated patients with asymptomatic carotid stenosis have declined so substantially, conducting new trials large enough to prove which morphological features can predict benefit from intervention has become a major challenge. The review calls attention to these limitations while affirming that the available data point in a consistent direction.\u003c\/p\u003e\n\n\u003ch2 id=\"recommendations\"\u003eRecommendations for Patients\u003c\/h2\u003e\n\n\u003cp\u003eBased on the findings of this review and the broader literature, patients with asymptomatic carotid stenosis should consider the following:\u003c\/p\u003e\n\n\u003col\u003e\n  \u003cli\u003e\n\u003cstrong\u003eTake medical therapy seriously.\u003c\/strong\u003e If you have been prescribed a statin, blood pressure medication, or antiplatelet drug, take it daily as directed. These medications work quietly in the background to stabilize plaques and reduce stroke risk. Never stop them without discussing with your doctor.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eQuit smoking—completely.\u003c\/strong\u003e If you smoke, the most powerful single step you can take to protect your brain is to stop. Ask your doctor about nicotine replacement therapy, counseling, or prescription medications that can double your chances of success.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAsk for a full ultrasound report.\u003c\/strong\u003e When you undergo a carotid duplex ultrasound, ask your doctor to explain not only the percentage of stenosis but also the plaque characteristics—whether it is fatty or calcified, whether the surface is smooth or irregular, and whether contrast-enhanced ultrasound showed vascularity within the plaque.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAttend scheduled follow-up ultrasounds.\u003c\/strong\u003e Since a high rate of stenosis progression is a risk marker, serial ultrasounds (often performed every 6 to 12 months) are important for detecting changes over time.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDo not assume surgery is required.\u003c\/strong\u003e If you are told you have a high-grade asymptomatic carotid stenosis, ask whether best medical therapy alone might be appropriate. Surgical treatment (endarterectomy) or stenting may be reserved for patients with high-risk plaque features, rapidly progressive stenosis, or symptoms.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eIf a procedure is recommended, ask why.\u003c\/strong\u003e Your doctors should be able to explain which specific features of your plaque or your clinical situation make you a candidate for intervention. A decision to operate should be based on your estimated individualized risk, not a blanket rule.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003ePatients should also remember that carotid stenosis is a marker of generalized atherosclerosis (hardening of the arteries throughout the body). A heart-healthy lifestyle—including regular physical activity, a Mediterranean-style diet, weight management, and blood sugar control if you have diabetes—protects the carotid arteries and the rest of the vascular system at the same time.\u003c\/p\u003e\n\n\u003c!-- ddn:faq:start --\u003e\n\u003ch2 id=\"ddn-faq\"\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eWhat is asymptomatic carotid stenosis?\u003c\/h3\u003e\n\u003cp\u003eAsymptomatic carotid stenosis is a narrowing of one of the main neck arteries supplying blood to the brain, with no prior mini-stroke or stroke on that side. It is often discovered incidentally during an ultrasound for another reason. The danger is that plaque pieces or clots can break off and cause a first-ever stroke.\u003c\/p\u003e\n\u003ch3\u003eHow is carotid artery narrowing detected?\u003c\/h3\u003e\n\u003cp\u003eDuplex ultrasound is the first-line test. It combines B-mode imaging, which shows the artery wall and plaque, with Doppler ultrasound, which measures blood flow speed. Faster flow indicates narrowing. This painless test involves no radiation or contrast dye and can be repeated safely to monitor changes over time.\u003c\/p\u003e\n\u003ch3\u003eWhy is surgery or stenting no longer recommended for every patient with asymptomatic carotid stenosis?\u003c\/h3\u003e\n\u003cp\u003eRecent improvements in medical therapy have dramatically lowered stroke rates in patients with asymptomatic carotid stenosis. For many patients, the risks of surgery or stenting, such as surgical stroke, heart attack, or nerve injury, now outweigh the potential benefit. Therefore, these procedures are reserved for higher-risk individuals rather than offered routinely.\u003c\/p\u003e\n\u003ch3\u003eWhich ultrasound features make a carotid plaque vulnerable?\u003c\/h3\u003e\n\u003cp\u003eA vulnerable plaque may appear dark (hypoechoic) on B-mode ultrasound, indicating a soft, lipid-rich plaque. Other risk features include a high rate of stenosis progression over time, a larger plaque area, surface irregularities or ulceration, and new blood vessel growth inside the plaque seen on contrast-enhanced ultrasound.\u003c\/p\u003e\n\u003ch3\u003eWho might still need surgery or carotid stenting?\u003c\/h3\u003e\n\u003cp\u003ePatients with high-risk plaque features, such as an ulcerated, hypoechoic plaque with intraplaque vascularization or a rapidly progressing stenosis, may benefit from intervention. The decision also considers overall life expectancy and the center's surgical complication rates. A procedure is recommended when the estimated stroke risk from the carotid disease exceeds the risk of the intervention.\u003c\/p\u003e\n\u003ch3\u003eWhat lifestyle changes are recommended for patients with asymptomatic carotid stenosis?\u003c\/h3\u003e\n\u003cp\u003eQuit smoking completely, as it is the most powerful single step. Take prescribed medications daily. Follow a heart-healthy lifestyle with regular physical activity, a Mediterranean-style diet, weight management, and blood sugar control if diabetic. Attend scheduled follow-up ultrasounds, often every 6 to 12 months, to monitor for progression.\u003c\/p\u003e\n\u003ch3\u003eI have asymptomatic carotid stenosis and was told I don't need surgery—when should I get a second opinion on whether stenting or endarterectomy is necessary?\u003c\/h3\u003e\n\u003cp\u003eFor asymptomatic carotid stenosis, surgery or stenting is no longer routinely recommended for everyone; stroke risk has fallen sharply with medical therapy. A second opinion is especially useful when a procedure is recommended despite no symptoms, because the decision now depends on plaque features—dark, ulcerated, rapidly progressing, or showing new blood vessels—plus your overall health and your center's complication rates. It is also reasonable to seek one if you are unsure why surgery was either advised or ruled out for your specific plaque. Diagnostic Detectives Network provides independent expert second opinions.\u003c\/p\u003e\n\u003c!-- ddn:faq:end --\u003e\n\n\u003ch2 id=\"source\"\u003eSource Information\u003c\/h2\u003e\n\n\u003cp\u003eThis patient-friendly article is based on a peer-reviewed review published in a Swiss medical journal. Here are the details of the original source:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eOriginal title:\u003c\/strong\u003e \"Duplex ultrasound in cerebrovascular disease - asymptomatic carotid stenosis\" [Article in German]\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAuthor:\u003c\/strong\u003e Daniel Staub\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAffiliation:\u003c\/strong\u003e Klinik für Angiologie, Universitätsspital Basel, Universität Basel (Clinic for Angiology, University Hospital Basel, University of Basel, Switzerland)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eJournal:\u003c\/strong\u003e Therapeutische Umschau (Therapeutic Review), 2018; Volume 75, Issue 8, pages 489–495\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDOI:\u003c\/strong\u003e 10.1024\/0040-5930\/a001029\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePMID:\u003c\/strong\u003e 31038044\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePublication date:\u003c\/strong\u003e 2018 (abstract available in English and German)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cem\u003eNote: This article is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition. Because this review was published in 2018, readers are encouraged to consult their healthcare team for the most current treatment recommendations.\u003c\/em\u003e\u003c\/p\u003e","brand":"DiagnosticDetectives.Com","offers":[{"title":"Default Title","offer_id":47471120351388,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"url":"https:\/\/diagnosticdetectives.com\/de\/products\/carotid-artery-narrowing-without-symptoms-how-modern-ultrasound-predicts-stroke-risk","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}