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Clinical Summary

Carotid Artery Stenosis: Screening

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Screening for Carotid Artery Stenosis: Clinical Summary of USPSTF Recommendation, 2014

Population Adults without a history of transient ischemic attack, stroke, or other neurologic signs or symptoms
Recommendation Do not screen for asymptomatic carotid artery stenosis in the general adult population.
Grade: D
Risk Assessment The major risk factors for carotid artery stenosis include older age, male sex, hypertension, smoking, hypercholesterolemia, diabetes mellitus, and heart disease.
Screening Tests All screening strategies, including ultrasonography with or without confirmatory tests (digital subtraction or magnetic resonance angiography), have imperfect sensitivity and specificity and could lead to unnecessary surgery and result in serious harms, including death, stroke, and myocardial infarction. There is no evidence that screening by auscultation of the neck to detect carotid bruits is accurate or provides benefit.
Balance of Benefits and Harms The harms of screening for asymptomatic carotid artery stenosis outweigh the benefits.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on many factors related to stroke prevention, including screening for hypertension, screening for dyslipidemia, the use of nontraditional coronary heart disease risk factors, counseling on smoking, and counseling on healthful diet and physical activity. In addition, the USPSTF recommends the use of aspirin for persons at increased risk for cardiovascular disease. These recommendations and related evidence are available at

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to

Current as of: July 2014

Internet Citation: Clinical Summary: Carotid Artery Stenosis: Screening. U.S. Preventive Services Task Force. March 2016.

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