Carotid Artery Occlusion || Doppler || Ultrasound || Case 266

Clinical Features:
A 75 years old male patient came with recurrent transient ischemic attacks.

Ultrasound Features:
- Severe luminal narrowing or stenosis of the left ICA with distal subtotal to total occlusion due to sonolucent (Type I) plaques. Left ICA shows monophasic flow at the proximal part & almost no flow signal distally.
- Moderate luminal narrowing or stenosis of both carotid bulbs due to uniformly echogenic & calcified (Type IV or V) plaques on the right & substantially sonolucent (Type II) plaques on the left.
- Mild luminal narrowing or stenosis of right ICA due to predominantly echogenic & calcified (Type IV or V) plaques & left CCA due to predominantly echogenic (Type III) plaques.

Remember:
In case of recurrent stroke, searching for soft plaques (Type I, II) in the carotid system is necessary to identify the cause of recurrence.

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