I believe if you look at the textbooks ( or least least the older ones) there is a diagnostic criteria of first 3 cm of the ICA for velocities. After the first 3 am the velocities are not "valid" for use since it was developed using only the first 3 cm. And the bulb portion is not included in that measurement since the bulb has variable location.
The real issue is that any diagnostic criteria used should have the parameters for use in the protocols. This would stop a lot of controversy.
    On Friday, May 10, 2019, 9:33:38 AM EST, Jones, Kimberly A <[log in to unmask]> wrote:  


Was anyone else taught to use the highest velocity of the only the proximal or mid ICA for grading criteria? The reasoning being that the distal portion of the ICA dives and can be falsely elevated – as well as surgeons aren’t able to intervene that distally. Also research into was used for only the first 2 centimeters of the internal carotid.


I can’t seem to find anything published that specifically states this – does anyone have any thoughts?

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