Echocolordoppler TSA and CT

What is it?

Supra-aortic artery trunk echocolordoppler (often referred to as "Carotid Doppler" or "Carotid Ultrasound" or "TSA Echocolordoppler") is a non-invasive, rapid, and accessible test to evaluate the anatomy and function of the major arterial branches that carry blood to the brain, face, and upper extremities (carotid arteries, vertebral arteries, and subclavian arteries). In addition to the echocolordoppler of the supra-aortic trunks, our Center is ready to provide the transcranial Doppler examination (CT), also in a combined manner. Transcranial Doppler allows the study of the main arterial branches contained within the skull, which supply the brain, brainstem and cerebellum. 

Supra-aortic arterial trunk echocolordoppler and transcranial doppler, with or without microbubbles, are highly operator-dependent examinations, i.e., their accuracy is highly dependent on the person performing them. In our Center, these examinations are performed by Neurophysiologists or Neurologists of the Stroke Unit (the unit that deals with the care of stroke patients), who are experienced and have performed a very high number of such examinations. In our Center, it is also possible to perform echocolordoppler examination of the temporal arteries (in case of suspicion of temporal or giant cell arteritis or Horton's arteritis) and of the venous vessels of the neck (in case of suspicion of venous thrombosis).

When is this exam indicated?

Echocolordoppler of the supra-aortic arterial trunks is requested to assess the presence or absence of wall changes or plaques related to aging or a vessel disease termed "atherosclerosis". It is also able to identify other arterial vessel pathologies, such as vessel wall dissection.

Atherosclerosis is a disease characterized initially by wall thickening and then by actual plaques ("atheromas") of the arteries, which are formed by the accumulation of cholesterol, inflammatory cells and fibrotic material, sometimes with calcium deposition. The origin of atherosclerosis is multifactorial, in part due to genetic predisposition, in part due to environmental factors, such as high blood pressure, diabetes mellitus, high blood cholesterol levels, overweight, cigarette smoking, sedentary lifestyle, etc.

Atherosclerosis of the supra-aortic trunks can cause strokes, memory and other cognitive impairments up to dementia, and posture and gait disturbances up to vascular parkinsonism. Therefore, the echocolordoppler of the supra-aortic arterial trunks is a test that allows to identify and prevent the so-called "vascular encephalopathy", acute or chronic, that is the suffering of the brain or other parts of the brain due to the closure (acute or progressive) of arterial vessels. Early detection of atherosclerosis in the carotid artery allows for treatments to reduce the risk of stroke, cognitive impairment, and Parkinsonism.

It is also important to remember that atherosclerosis is a systemic disease, affecting arterial vessels of various body areas (including heart and coronary arteries, aorta and lower limbs, in addition to supra-aortic trunks). Therefore, the study of the arterial vessels of the neck, easily performed by echocolordoppler of the supra-aortic trunks, also allows to establish the risk of involvement in other body areas by atherosclerosis. Early diagnosis allows the use of preventive therapies (of stroke, heart attack, etc.), increasingly important with the increase in the average life of the population and, therefore, the incidence of these diseases.
The transcranial Doppler, combined with the use of "microbubbles" of saline solution, allows to verify if there are shunts between venous and arterial vessels of our body, or direct connections that bypass the pulmonary filter. These shunts are often associated with the presence of a frequent congenital anomaly, the so-called "pervious foramen ovale". Transcranial Doppler-detected shunts with microbubbles (and pervious foramen ovale) have been associated with a fair proportion of strokes, especially at younger ages, and also in persons without conventional risk factors for stroke.

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How is it performed?

It is an ultrasound of the neck with a particular method that allows the study of wall and the study of blood flows in the vessels. The duration of the examination is approximately 15-20 minutes, except for some special situations that require longer times.


There are no contraindications. The examination is completely non-invasive. As already explained, it is an operator-dependent examination, therefore the quality of the report strongly depends on the experience of the physician and on the machines used.

Where do we treat it?

At GSD you can find Exams specialists at these departments:

Are you interested in receiving the treatment?

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