CAROTID DUPLEX SCAN - 5

CAROTID DUPLEX SCAN

FINDINGS:               The present study was compared with the previous study of 06/10/2011.  Correlation was also made with CTA of the carotid arteries performed on 09/20/2011.

On the present study, once again total occlusion of the right carotid system is noted.  The velocity of the blood flow in the left common carotid artery is 122 cm/sec proximally, in the distal left common carotid artery, it is 136 cm/sec.  In the proximal left internal carotid artery, it is 128 cm/sec and in the left distal internal carotid artery, it is 137 cm/sec.  Antegrade blood flow was seen in the left vertebral artery.

The ICA/CCA ratio on the left is 1.01.

IMPRESSION:         About 55% stenosis of left internal carotid artery.  There is apparent discrepancy in comparison with the previous study of 06/10/2011, which showed about 80% stenosis of the left internal carotid artery.  This may be related to the technical factors.  Clinical correlation and further evaluation with catheter-directed angiography is recommended.

Total occlusion of the right internal carotid artery with no significant interval change in comparison with previous study.

Thank you for the referral.

XXXXXXXXX, M.D.

CAROTID DUPLEX SCAN - 4

CAROTID DUPLEX SCAN

FINDINGS:             Minimum plaque formation is seen involving left internal carotid artery.

Intimal thickening is seen involving the right internal carotid artery.  However, there is no plaque formation.

The velocity of the blood flow in the right common carotid artery is 95 cm/sec, in the right internal carotid artery, it is 85 cm/sec, and the right external carotid artery, it is 111 cm/sec.  The velocity of the blood flow in the left common carotid artery is 161 cm/sec, in the left internal carotid artery, it is 93 cm/sec, and in the left external carotid artery, it is 81 cm/sec.  These values are within normal limits.

The ICA/CCA ratio on the right is 0.89 and on the left it is 0.58 and this is within the normal range.

IMPRESSION:        No evidence of significant plaque formation or stenosis.

Thank you for the referral.

XXXXXXXX, M.D.

CAROTID DUPLEX STUDY

CAROTID DUPLEX STUDY

FINDINGS:             Mixed plaque formation is seen involving the bulbar region of both common carotid arteries and proximal internal carotid arteries bilaterally.

The velocity of the blood flow in the right common carotid artery is 64 cm/sec, in the right internal carotid artery it is 54 cm/sec, and in the right external carotid artery it is 70 cm/sec.

The velocity of the blood flow in the left common carotid artery is 64 cm/sec, in the left internal carotid artery it is 70 cm/sec, and in the left external carotid artery it is 55 cm/sec.  These values are within normal limits.

Antegrade blood flow was seen in the vertebras.

The ICA/CCA ratio on the right is 0.83 and on the left, it is 1.10 and these values are within the normal range.

IMPRESSION:        About 40% stenosis of proximal right internal carotid artery and about
40-50% stenosis of proximal left internal carotid artery, not hemodynamically significant.

Thank you for the referral.

XXXXXXXX, M.D.

CAROTID DUPLEX SCAN - 3

CAROTID DUPLEX SCAN

FINDINGS:               Duplex scanning of the carotid vessels shows atheromatous change involving the bilateral carotid system.  There is increased velocity seen in the right internal carotid artery and the ICA/CCA ratio of 2.3 in the right carotid system would suggest a stenosis of 60-79%.  The ICA/CCA ratio of 1.6 on the left would indicate a stenosis of 40-59% involving the left carotid system.

In view of the above findings, a carotid MRA would be indicated and of value.

IMPRESSION:         Severe stenosis of the right carotid system.

Thank you for the referral.

XXXXXXX, M.D.

CAROTID DUPLEX SCAN - 2

CAROTID DUPLEX SCAN

FINDINGS:               Duplex scanning of the carotid vessels shows atheromatous changes bilaterally, somewhat greater on the right than on the left.  Stenosis is estimated perhaps 52% on the right and 32% on the left.

The ICA/CCA ratio is 0.99 on the right and 0.66 on the left.  There is no significant increase in velocity.

IMPRESSION:         Atheromatous changes as noted, but no significant hemodynamic effects are identified.

Thank you for the referral.

XXXXXXXX, M.D.

CAROTID DUPLEX SCAN - 1

CAROTID DUPLEX SCAN

FINDINGS:               Duplex scanning of the carotid vessels shows no significant atheromatous change.  In fact, very minimal plaque formation is identified.

The velocity of flow measurements remained within a normal range.  The ICA/CCA ratio is measured at 0.53 on the right and 0.35 on the left.

IMPRESSION:         Normal carotid duplex scan.

Thank you for the referral.

XXXXXXXXX, M.D.

BILATERAL CAROTID ANGIODYNOGRAM

BILATERAL CAROTID ANGIODYNOGRAM

FINDINGS:               A bilateral carotid angiodynogram was performed.  Duplex velocity measurements, gray scale evaluation, and color-flow evaluation, along with real-time B-flow evaluation of the vasculature, was obtained.

There is approximately a 25-30% stenosis on the right and a 40% stenosis on the left.  The velocity measurement on the right is 118 with ratio of 1.08 and on the left is 91 with ratio of 0.92.  There is no significant occlusion.  The remainder of the visualized external and common carotid arteries, and proximal subclavian arteries show no significantly elevated velocity measurements to suggest critical stenosis.

If there is any further clinical concern, CTA or MRA evaluation may be considered.

IMPRESSION:          25-30% stenosis on the right and 40% stenosis on the left.  If there is any further concern, would recommend clinical correlation and further evaluation as clinically necessary.

Thank you for the referral.

XXXXXXXXX, M.D.