A criticism of duplex scanning of the carotid vessels is that the study is limited to evaluation of the carotid bifurcations, whereas with other vascular imaging studies the vertebral vessels can also be seen. We have prospectively collected data on our ability to evaluate the vertebral vessels on all patients who are sent for carotid evaluations. We have scanned 677 patients and have identified flow in one or both vertebral arteries in nearly 90% of these patients. Therefore, we urge that evaluation of vertebral vessels be made a routine part of the standard carotid duplex ultrasound examination.

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