Table 2.1.

Limited Screening Study for Carotid Artery Plaque—Asymptomatic^*

Indication		Appropriate Use Score (1–9)
30.	• Low Framingham risk score • No prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement	I (2)
31.	• Intermediate Framingham risk score • No prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement	U (4)
32.	• Low or intermediate Framingham risk score • Normal prior risk assessment imaging study, such as coronary calcium scoring or carotid IMT measurement	I (3)
33.	• High Framingham risk score	U (5)

A = appropriate; I = inappropriate; IMT = intima-media thickness; U = uncertain.

^*A screening carotid duplex examination includes assessment for the presence of atherosclerotic plaque within the common and internal carotid arteries using grey-scale imaging and assessment for stenosis of the proximal internal carotid artery using spectral Doppler. The screening carotid duplex examination is performed using a limited but clearly defined screening protocol (see ICAVL 2010 standards 5.1.5).³ A screening study for carotid artery plaque does not include formal measurement of carotid intimal medial thickness.