Brachiocephalic trunk stenosis


Parvus et tardus (slow-rising, late-arriving) Doppler waveform indicates the presence of proximal stenosis. Bidirectional flow within the right vertebral artery indicates that the site of stenosis is proximal to the vertebral artery origin.

In this case, ultrasound can accurately localize the site of obstructing lesion to the brachiocephalic trunk; confirmed with CT.