PMC6551505_01
Doppler ultrasonography pictures of the right intern carotid showing the evolution of stenosis at diagnosis (August 2014, A and B), after one year (May 2015, C and D) and before endarterectomy (February 2017, E and F). The thrombosis of right intern carotid was estimated at around 10-30% at first examination (A), evolved to almost 50% after one year (C), then progressed to 70% (E), which was the indication for a surgical intervention. If this stenosis had no consequences on flow velocity at first discovery (75 cm/s, B), it rapidly evolved to an increase of this parameter above the pathological threshold of 125 cm/s (158 cm/s at 50% stenosis, D, and 190 cm/s at 70% stenosis, F).
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This examination detected a hypoechogenous, homogenous, regular patch on the right intern carotid (estimated stenosis of about 10-30%), without hemodynamic effect (Fig. 1A and B). The stenosis was around 50% and had hemodynamic consequences, with a velocity of 158 cm/s, a value which is above the threshold of 125 cm/s defined by the European Society of Cardiology (Fig. 1C and D). Although the patient remained asymptomatic, a control doppler ultrasonography of supra-aortic arteries performed in February 2017 found a right intern carotid stenosis of about 70% with a velocity of 190 cm/s (Fig. 1E and F).