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JAMA Surgery Clinical Challenge
January 2015

Symptomatic Carotid Stenosis

Author Affiliations
  • 1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Emory University, Atlanta, Georgia
JAMA Surg. 2015;150(1):79-80. doi:10.1001/jamasurg.2014.376

A woman in her early 60s with a history of hypertension and hyperlipidemia was transferred to our hospital after multiple transient ischemic attacks and left internal carotid artery (ICA) stenosis during the past several months. Her most recent presentation was 1 week prior for a minor stroke with amaurosis fugax, slurred speech, right-sided weakness, and facial droop lasting longer than 24 hours. Magnetic resonance imaging of the brain demonstrated subacute infarctions involving the left frontal and parietal hemispheres. She was a current smoker and was taking aspirin and statin medication at the time of presentation. Workup at another facility prior to transfer included computed tomographic angiography of the neck, which showed chronic occlusion of the right ICA and 95% stenosis of the left ICA.

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