On physical examination, the most important finding is the presence of a carotid bruit. Although a carotid bruit is not pathognomonic for carotid stenosis, studies at the Johns Hopkins Hospital suggest a 40-percent positive predictive value for carotid stenosis (in excess of 70 percent) in CABG populations. From a demographic perspective, increased age, cerebrovascular disease (CVD), and peripheral vascular disease also greatly increase the likelihood of carotid disease. For patients at risk for carotid disease, duplex ultrasound represents a noninvasive means of assessing carotid disease quantitatively. Magnetic resonance angiography, cerebral angiography, and computed tomography (CT)–angiography represent more costly and/or invasive methods of assessing the degree of stenosis that may be useful in confirming duplex findings and in instances in which duplex results are indeterminate.