Though DSA remains the gold standard in some facilities in follow up studies after CEA, its use is declining due to the complications it presents and to the development of other diagnostic modalities. Three-D CTA with a high-performance workstation provides detailed images with satisfactory information, though it also presents the problems of X-ray exploration and allergic reaction to contrast media. Duplex US is a handy, non-invasive, real-time technique, but is limited due to its operator dependency and low resolution. MR angiography is promising, though it is still being developed at present. By providing greater accuracy both in the assessment of the degree of stenoses and in the characterization of plaque contents, and with the important advantage of being less invasive, since it is a non-X-ray examination, MRA may well obtain preeminence in the postoperative follow up study of carotid endarterectomy.
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