A 75 years-old nonsmoking female with history of hypertension, chronic obstructive pulmonary disease presented to Republican Cardiac Center with severe dizziness, headaches and visual disturbances. Auscultation revealed systolic bruit above left carotid artery bifurcation. Neurologic exam was uneventful.
Relevant test results prior to catheterization
Workout with carotid ultrasound revealed right ICA stenosis 65-70% with bifurcation up to 50%, left ICA 55-60%. CT with contrast of aortic arch with main branches found type III aortic arch with erosive calcified atherosclerotic plaque, ostial stenosis of left subclavian and left CCA.