Presentation
Routine evaluation for carotid artery stenosis.
Patient Data
A circumscribed, heavily calcified atherosclerotic stenosis of the right carotid bifurcation can be observed, which causes complete acoustic shadowing, hence the exact degree of area stenosis cannot be precisely estimated. Nevertheless the spectral curves and velocities in the prestenotic part of the CCA and the poststenotic ICA and ECA branches are within normal range, thus excluding critical stenosis (note that in case of the ICA the sample box appears seemingly off-centre due to the low image refresh rate of triplex US imaging).
The pathology can be better appreciated in the cine loop, in the proximal part of the ICA immediately distal to the plaque a circumscribed colour aliasing artefact can be discerned, indicatening turbulent blood flow.
Case Discussion
Typical presentation of circumferential carotid bifurcation stenosis, which displays no significant poststenotic flow disturbances. Further close follow-up is nevertheless warranted.
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