High-grade left internal carotid artery stenosis

Case contributed by Brendan Cullinane

Presentation

An elderly lady suffering from vertigo.

Patient Data

Gender: Female

Left carotid arterial system

ultrasound

The left internal carotid artery stenosis is classified as a high-grade (80-99%) stenosis by the University of Washington criteria (PSV >125 cm/s, EDV >140 cm/s) and a high-grade (>70%) stenosis by the NASCET criteria (ICA/CCA ratio >4).

Case Discussion

Based on the data (PSV = 736 cm/s, EDV = 264 cm/s, ICA/CCA = 11.5), the stenosis would likely be closer to 99% than the lower end of the above ranges.

A high-grade >50% left external carotid artery stenosis was seen (not shown). The right carotid arteries were unremarkable and antegrade flow was observed in both vertebral arteries (not shown).

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