Pre and post stenosis velocities and pre and post aneurysm diameters are something we do, as well. IAC standards are pretty clear on requiring pre and post images. As I mentioned before, if you're somewhere that you were going to take a standard image, anyway, just annotate it as pre or post (as long as it is). If you're not, it's only two more images. My understanding, however, is that it's more about annotating, so everyone knows what you're showing them. Even though ICA stenoses are not evaluated on step ups, I think there is some value in documenting the waveform proximal to the stenosis, as this can tell us something about what's coming up. Especially in heavily calcified arteries, where we might be missing the tightest area of stenosis.
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