CCI Cerebrovascular Duplex Examinations 4

Question 1

Which Doppler spectral finding is MOST consistent with external carotid artery identification during carotid duplex?

Accepted Answer

High-resistance waveform with little or absent diastolic flow

Answer

The ECA supplies high-resistance facial musculature, producing a high-resistance waveform with minimal diastolic forward flow.

Question 2

Which criterion best distinguishes a 50–69% ICA stenosis from a <50% stenosis using the SRU consensus guidelines?

Accepted Answer

PSV ≥125 cm/s and ICA/CCA ratio ≥2.0

Answer

SRU criteria classify 50–69% ICA stenosis as PSV 125–229 cm/s and ICA/CCA PSV ratio 2.0–4.0.

Question 3

When assessing for vertebral artery occlusion, which finding would support the diagnosis?

Accepted Answer

Absent color flow and Doppler signal despite optimal technique

Answer

Absent flow signal with proper technique and confirmed vertebral artery visualization on B-mode is indicative of vertebral artery occlusion.

Question 4

In the evaluation of carotid artery dissection, which duplex finding is MOST commonly observed?

Accepted Answer

Eccentric hypoechoic thickening of the arterial wall with luminal narrowing

Answer

Carotid dissection produces an intramural hematoma seen as eccentric hypoechoic wall thickening that narrows the true lumen.

Question 5

A post-carotid endarterectomy patient shows a focal PSV of 280 cm/s at the operative site 6 months later. What is the most appropriate interpretation?

Accepted Answer

Likely myointimal hyperplasia causing significant restenosis

Answer

PSV ≥260 cm/s at a CEA site within 2 years typically indicates myointimal hyperplasia–related restenosis, which is the most common early cause of recurrent disease.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Cerebrovascular Duplex Examinations 4