Which artery is most commonly evaluated when performing a carotid duplex exam?

The internal carotid artery is the primary focus during a carotid duplex exam because this artery is critical for blood supply to the brain. Evaluating it helps to identify any abnormalities such as stenosis, occlusion, or plaques that could lead to cerebrovascular events, including strokes.

The internal carotid artery runs from the bifurcation of the common carotid artery up to its branches in the cerebral circulation; thus, it is essential to assess this vessel for its diameter, flow characteristics, and the presence of any pathologies. The duplex ultrasound combines both traditional ultrasound imaging and Doppler flow studies, enabling comprehensive analysis of this artery's condition.

While the external carotid artery and other vessels may also be evaluated in some cases, the internal carotid artery is the most pertinent because of its direct relationship to cerebral perfusion and the high risk of vascular compromise represented by pathologies occurring in this vessel. This emphasizes the importance of accurately assessing the internal carotid artery during a carotid duplex exam.